Cataract Eye Surgery
WHAT IS CATARACT?
The human crystalline lens, which is clear and transparent is part of
the focusing mechanism of the eye. With age, the lens becomes cloudy and opaque, thereby
hampering normal vision. Any opacity in the crystalline lens, which leads to decreased
vision, is cataract.
The early cataractous lens bends light irregularly, so the images formed are blurred and
unclear. When opaque, the cataract may cut off light nearly in total, causing blindness
(reversible).
What causes Cataract ?
Ageing is the most common cause. With age, proteins of the eye lens get altered and
opacified leading to cataract. Other causes include congenital and developmental anomalies,
trauma, inflammation of the eye, metabolic diseases like Diabetes, Hypothyroidism etc.,
What are the common symptoms of Cataract ?
Cataract makes simple tasks difficult and in some cases impossible to perform.
What are the treatment options for Cataract ?
Surgery is the only course of treatment for cataract. There are two options available
for cataract surgery
Conventional Cataract surgery or Extra Capsular Cataract Extraction (SICS/ECCE)
Injections are given near the eye
- Requires an incision of 7-8 mm
- The cloudy eye lens is removed in one piece
- A hard plastic lens is implanted
- Multiple Stitches are required in ECCE
- Final glass prescription could take even upto 10 weeks
This happens on account of :
- Cloudy or Blurred Vision
- Changes in one's perception of colours
- Sensitivity to bright lamps or sunlight
- Poor night vision
- Difficulty in driving especially at night
- Frequent changes in eye glass prescription
- Sensitivity to bright lamps or sunlight
Conventional Surgery Wound Microincision Cataract Surgery (PHACOEMULSIFICATION)
- Requires a very small incision of 1.5 - 2.8mm
- Cataract Extraction with Phacoemulsification is followed by
- foldable lens implantation :
- Walk-in Walk-out procedure
- Stitchless, bloodless, painless surgery
- Chances of infection are very low
- Minimum post surgery precautions
- Quicker healing and recovery
- Phacoemulsification Microincision
When to go for Cataract Removal?
Cataract should be removed as soon as it begins to affect daily activities. With any of the
above mentioned symptoms setting in, it is the right time to go for Cataract removal.
DO NOT WAIT FOR THE CATARACT TO GET MATURE as unnecessary delay can lead to avoidable
complications and more difficult surgery.
Cataract surgery can be undertaken successfully in any season. Summer or rainy season have
absolutely no effect on the outcome of the cataract surgery.
What is the recommended treatment for cataract ?
With phacoemulsification and implantation of foldable Intra Ocular Lens (IOL), treatment of
cataract has become very simple and sophisticated. The procedure is safe,
accurate and leads to rapid recovery. Thus phacoemulsification with foldable lens implant is the
most recommended treatment for cataract.
What is phacoemulsification with foldable IOL ?
In phacoemulsification, ultrasound power is used to break the hard cataract into minute pieces,
which are then sucked out through a small 1.5-2.8mm incision.
A foldable lens (IOL) of the required power is then implanted. The soft construction allows the
lens implant to be folded for insertion through a 1.5 to 2.8mm micro incision.
Once in place, the lens unfolds to its regular size of 6 mm.
PHACOEMULSIFICATION FOR CATARACT
Phaco Incision
IOL Insertion
Phaco In Progress
Post IOL
What are the advantages of phacoemulsification with fold-able IOL over conventional cataract
surgery ?
- It allows for a injection less, stitch less, painless, no bandage surgery
- Drops of local an-aesthetic agent are used instead of an injection in the eye, thus leading
to a walk-in
- walk out procedure
- Early visual rehabilitation for the patient
- Minimum curvatural changes occur in the eye following surgery
- Post surgery, the wound is very secure
- Final glasses can be prescribed within two weeks
How soon after phaco surgery, will I be able to see ?
In some cases, the patient is able to see almost immediately following the surgery, although
most patients experience clear vision after one or two days
Will I need glasses after phaco surgery?
You may need to wear glasses only to fine -tune your vision. These spectacles have normal lenses
unlike thick lenses used in the past. If unifocal IOL is used,
near vision glasses are almost always required.
Will activities have to be restricted after phaco surgery ?
Normal activities including walking, reading, writing, watching television etc. may be resumed
soon after the surgery. However, during the first week after the surgery,
it is better to avoid strenuous activities & avoid exposing the eye to water or dust.
Is there any diet restriction after phaco surgery?
There are absolutely no diet restrictions after phaco and you can continue with your normal
diet. However, diet regulation advised for other diseases like Diabetes,
High blood pressure, etc must continue.
Can I have phaco surgery on one eye even if the other eye had been operated upon by the
conventional surgery ?
Yes, you may have micro incision Phaco surgery on your "Second Eye" provided there is no
specific contraindication for Phaco.
How long will the procedure take ?
With the advanced technique of the cataract surgery, removal of the cataract takes just about 2
minutes and the entire procedure would take about 5-8 minutes.
All procedures are done with advanced operating microscopes form Carl Zeiss (Germany) &
Signaturephacoemulsification system with ellips Technology and Sovereign phacoemulsification
system with ICE Technology
Multifocal IOL :
The latest multifocal IOLs are designed to provide good distance vision, intermediate and near
vision. They reduce the patient's dependence on glasses for routine activities. Unlike
conventional
IOL it has multiple zones of different focal lengths that bring everything from near to far into
clear focus. These lenses can be used only for suitable patients.
The Signature / Sovereign Advantages
Signature / Sovereign are the latest generation phacomachines as of now. Working on
microprocessor based technology, they allow the use of high vacuum during surgery. The use of
vacuum of upto 650mm Hg
helps reduce the energy required for phacoemulsification. This leads to reduced surgery time,
less trauma to the eye tissues, less post operative reaction leading to faster visual recovery
and allows even very advanced cataract to be removed by phaco itself. These machines also have
non-contaminant tubings which reduce the incidence of infection. Nethradhama Superspeciality Eye
Hospital has opted for the latest techonologies in phaco keeping in mind the extraordinary
procedural safety it offers.
The Signature / Sovereign Advantages
Nethradhama Super Speciality Eye Hospital is a High-tech Eye hospital offering comprehensive eye
care facilities with the state-of-the art technology to treat various eye disorders. Nethradhama
is an icon of dynamic progress in the field of Ophthalmology. The hospital has the distinction
of being the First Super speciality Eye hospital in India to be accredited by the National
Accreditation Board for Hospitals & Healthcare providers (NABH), a constituent board of Quality
Council of India (QCI)
which focuses on patient safety & quality of care.
Centurion
Today’s phacoemulsification systems incorporate plenty of advanced technology and clever design
elements that make cataract surgery safer, faster and less taxing for the patient. A big part of
that is fluidics—the way in which fluid is moved through the eye during surgery, which impacts
how easily broken-up nucleus fragments are removed from the eye. The Alcon’s Centurion Vision
System features what is called as Active Fluidics Technology. Most Fluidic Systems are
gravity-fed; that is a bottle of BSS is hung above the patient’s head and gravity provides the
adequate pressure needed to maintain inside the patient’s eye during the surgery. In contrast,
the Centurion’s Active Fluidics system maintains the target pressure inside the eye using a
variable; rather than a static input pressure. This is achieved by inserting the bag of fluid
into the machine which is then acted upon by pressure plates that are able to change the
pressures very rapidly in response to the feedback from the sensors. The Centurion fluidics
control system is so adaptive and adjustable that it allows automation of the process of
cataract removal. The Active Fluidics system maintains the intraocular pressure, helping to
maintain a very stable anterior chamber.In concert with the Intrepid Balanced Tip probe, it
becomes a powerful emulsification unit that uses Ozil technology which requires less energy and
thereby minimising the risk of damage to cornea significantly.
ARTEVO 800
From the leader in optics for more than 170 years, ARTEVO® 800 from ZEISS unleashes a new era of
ophthalmic surgical visualization. The industry’s first digital microscope, ZEISS ARTEVO 800
adds a new dimension to the surgical workflow. It also gives an advantage of improved heads-up
ergonomics to the surgeon. The ARTEVO 800 is a game changer in the field of ophthalmology
providing the most advanced technology in ophthalmic visualization. ZEISS ARTEVO 800 includes
the new AdVision feature, which places relevant information directly in the surgeon’s line of
sight, including cataract assistance functions that can be fully controlled by the surgeon. This
gives a better and more control during surgery for a smooth surgical workflow. These assistance
overlays prove beneficial for each step of surgery, such as marker-less toric IOL alignment etc.
ZEISS ARTEVO 800 also reduces the light intensity required for the surgery thereby significantly
enhancing patient comfort. In addition to the same it provides a greater depth of field and
enhanced contrast to the surgeon helping him deliver the best possible outcome to the patient.
Equipment and Facilities
