DR. ASHOK EYE HOSPITAL

Cataract and Cataract - Refractive Surgery

Cataracts occur when the natural lens of the eye becomes cloudy, causing vision impairment. Cataract surgery is one of the most common and successful procedures performed to restore clear vision.

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Refractive Surgery

Refractive surgery refers to a range of procedures designed to correct refractive errors like nearsightedness (myopia), farsightedness (hyperopia), astigmatism, and presbyopia.

Cataract and Cataract - Refractive Surgery

Eyes have an important structure called lens, which helps focus the rays of light on to the retina. Clouding or opacification of the lens is cataract.

This may be present at birth or occur due to injury but the most common variety is related to age (Senile Cataract). This is the most common cause of visual disability in the aged population.

Cataract is the Commonest Cause

Cataract is the commonest cause of preventable blindness in the world. The treatment is surgical with replacement of the opacified lens with an artificial intraocular lens.

The current method of performing suture less surgery with a small incision by using the phacoemulsification machine and the introduction of a foldable lens results in early visual rehabilitation.

Centre for Eye and Health Care (CEHC)

Centre for Eye and Health Care (CEHC) is equipped with the latest microscopes and phacoemulsification machines and the surgeries are done in modern operating theatres with standards as defined by NABH and with disposable consumables from companies of repute for optimal results.
The options of cataract removal are, manual or by phacoemulsification.

Manual cataract removal
Manual cataract removal is now days done by a large sutureless self-sealing wound, where the nucleus of the cataract is removed manually and the remaining cortical matter is aspirated and then a lens is placed. The healing time is slower and the chances of inducing a higher postoperative power is more.
Phacoemulsification
on the other hand uses ultrasound energy to cut, emulsify and aspirate the cataract through a self-sealing small incision. Current technology advancements and newer techniques helps the surgeon perform phacoemulsification in nearly 100% of the cataracts. Visual rehabilitation is rapid. It is a however a highly skilled procedure and the experience of the surgeon counts as it amounts to working in a 6mm area with a phaco probe vibrating at 60000 MHz The current phaco technology allows safe and fast cataract removal through sub 2mm incisions and the placement of modern monofocal / trifocal/ toric lenses in the bag to give rapid and less spectacle dependant vision
Femtosecond cataract surgery
Femtosecond cataract surgery or “Laser” cataract surgery is the current method where the entry to the eye, the opening in the capsule and dividing the nucleus is done with the help of laser thereby avoiding the use of blade, therefore it is also called “bladeless surgery”. After opening the capsule the rest of the surgery is done by phacoemulsification.
Following cataract removal, visual rehabilitation occurs with placing of the lens in the eye. In today’s world, all eyes must have an intraocular lens(IOL).

Intraocular lens(IOL).

The best lens material in use today is acrylic which makes the lens foldable and can therefore be inserted through a small incision. Intraocular lens (IOL) could be monofocal, extended depth (EDOF) or trifocal and toric or non toric. Some of these lenses like trifocal or EDOF IOLs significantly decrease the dependency on glasses for good vision, most patients are spectacle independent. Toric lenses, while they do not promise spectacle independence, significantly lower the cylindrical power in the eye thereby improving the quality of vision tremendously.

IOL and The techniques

The type of IOL and the techniques to be adopted depends on the eye condition, type of cataract, cost and requirement of the patient. It is best to discuss with your surgeon and decide on the type of lens suited for you.

There are many cataract scenarios where additional gels are needed to protect the surrounding structures while emulsifying the nucleus of the cataract or hooks are needed to dilate the pupil or rings are used to stabilize the capsular bag before placing the IOL. Often the surgeon can predict the need, sometimes the need to use these are taken peroperatively. The cataract surgeon sometimes suspects or observes a lack of adequate support for placing the type of IOL initially discussed and changes the model while doing the surgery, for better stability and long term safety of the eye. Such spontaneous decisions are best left to the operating surgeon. Rarely, the cataract cannot be removed in its entirety or sinks into the vitreous cavity and calls for a second sitting to remove it and place a IOL. These situations are less commonly encountered.

Please Note......

"Medicines or laser or frequent change of glasses cannot remove the cataract or delay its progression."