Cataract Eye Surgery

Cataract Eye Surgery

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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)
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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)
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  • 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
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Phaco Incision
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IOL Insertion
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Phaco In Progress
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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 ?

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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

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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

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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