Cataract



Cataract surgery is one of the safest, most
effective types of surgery. It's also one of
the most successful.

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  • Requires an incision of 10-12mm
  • Clouded lens is removed in one piece A non-foldable lens is implanted
  • Multiple stitches are required
  • More chances of high post operative cylindrical number astigmatism.

 

2. Micro-incision cataract surgery - phacoemulsification-a modern technique.
Phacoemulsification is the latest technology in cataract surgery. It is a micro-incisional stitch less operation where cataract is emulsified by ultrasound energy, liquefied & sucked through the phacoemulsifier probe. Then a foldable intra-ocular lens is implanted in the eye permanently.

It is least traumatic form of cataract surgery with early rehabilitation & recuperation. Vision restoration is possible in a short period of time. (pictures)

cat cat

Phaco Handpiece

 

Advantages of Phacoemulsification:
The operation is atraumatic to the eye

Day care procedure without the requirement of hospitalization overnight.

      • Operation is performed by putting local anaesthetic drops without giving any injection in most cases. Hence no patch is necessary after the surgery.
      • Least chances of infection
      • Quicker healing and recovery
      • The patient gets good quality vision within 24-48 hours
      • Minimum post-op precautions
      • The patient can resume professional work in the shortest possible time.
      • One may need to wear glasses only to fine tune one's vision. Although glasses will be necessary for clear near vision.
      • One can reimburse the cost for the surgery through Mediclaim.


LENS IMPLANT

During cataract surgery, natural lens of the eye that has turned opaque is removed, resulting in loss of focusing power of the eye. This situation would be parallel to taking photograph without a camera lens - picture would be extremely blurred. When the natural lens of the eye is removed an artificial implant is placed in the eye.

Intraocular Lens (IOL)
IOL may be rigid or flexible. The flexible IOL's are made from either Silicone or Polydroxymethacrylate so that they can be folded to allow insertion through a much smaller incision than rigid IOLs. Posterior Chamber -(PC) IOL s lie behind the iris & have flexible haptics. Anterior Chamber (AC) IOL s lie in front of iris & have flexible or semiflexible angle supported haptics. These are now mainly used if post capsule is accidentally ruptured during surgery.

INDICATIONS FOR CATARACT SURGERY:

      1. Visual improvement
      2. Medical indications are those in which the presence of a cataract is adversely affecting the health of the eye e.g lens induced glaucoma
      3. Cosmetic indications -A mature cataract in an otherwise blind eye is removed to restore a black pupil.


HOW DO I DECIDE WHETHER TO HAVE A CATARACT SURGERY?

Tell your doctor how your cataract affects your vision & your life, you & your doctor can decide accordingly

      1. I do not see well enough to do my best at work.
      2. I do not see well enough to do things I need to do at home.
      3. I do not see well enough to do things I like to do (e.g T.V; sew, play cards, go out with friends)
      4. I am afraid I will bump into something or fall.
      5. I am not as independent as I would like to be.
      6. My glasses do not help me see well enough.
      7. My eyesight bothers me a lot.
      8. Driving is a problem - too much glare from sun, headlight.


BENEFITS & RISKS OF CATARACT SURGERY:

BENEFITS
Improvement in activities - driving /reading /working /social activities/ hobbies

RISKS
Some of the possible complications are:

      1. High pressure in the eye
      2. Blood collection in the eye
      3. Infection
      4. RD (Retinal detachment)
      5. Swelling /clouding or cornea


REMEMBER:

Freedom from blurred vision gives you the freedom to enjoy your life to its fullest extent!!

What you should know / do before going for surgery
General health status should be known. Any active diseases should be treated before surgery. Preoperative investigations like blood tests, ECG, Glucose recorded.

Carry out the pre-operative instruction as per the scheduled date & time.

PRE-OPERATIVE INSTRUCTIONS:

      1. To have light breakfast 4 hrs before arriving at the hospital.
      2. To put the eye drops as instructed 3 day prior to the date of the surgery & in the morning of the day of surgery in the eye to be operated.
      3. To take the dose of regular medication which you are already taking.
      4. To take head bath and dress comfortably.
      5. To be accompanied by not more than 2 persons.
      6. To carry the operation file, reports, sunglasses and necessary medication.
      7. To register at the reception counter for admission.
      8. To read and sign the consent form for the operation and take instructions form the optometrist.
      9. If for some reason you have any questions, the doctor or one of the optometrist would be able to answer them before the surgical treatment is begun.
      10. To stop blood thinning or any anti-inflammatory medications including Aspirin 3 days prior to the surgery day.
      11. Plan to have someone drive you home following surgery.
      12. Plan to have a parent or legal guardian with a disabled person.
      13. If any change in appointment, call up at the center & inform a day prior to the date of operation.
      14. Wear comfortable clothes.
      15. Do not apply make-up or wear jewellery.
      16. Do not carry expensive goods with you.


Area of operation:

The assistant will take you to the area where you would be prepared for the surgery. You will change into surgical clothes, cap, etc.

Pre-operative medication will be administered by way of anaesthetic drops, injections or sedatives if necessary. One person will help you to enter the operating room and lie down on the operation table, you will always have someone by your side to assist and help you during the operation.

Surgical wash:
The two eyelids will be carefully cleaned with the anti bacterial solution and drops will be put to clean the eyes and to make the area sterile during the surgical procedure.

After surgery:
The assistant will help you to leave the operation theatre and go to the recovery room where you will need to rest for some time. After this, the person who has accompanied you, can take you home to rest.

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