|
|
| How does the eye function normally?
|
 |
The light is refracted by the cornea and the normal lens and gets focused on the retina. This enables us to see clearly. |
|
 |
|
|
| What is Cataract? |
|
Cataract is the opacification of the crystalline lens of the eye. The lens is a transparent structure whose transparency may be disturbed due to degenerative process. This may lead to opacification of the lens fibres and this development of opacity in the lens is known as cataract.
The opacity of the lens scatters the light and prevents it from focusing light on the retina and hence causes blurring of vision.
|
 |
|
|
|
|
|
| Why does Cataract Form? |
|
| Cataract formation is part of normal aging process. It is usually seen after 60 though sometimes earlier also. It may be precipitated earlier by diabetes, drugs like steroids, injury, certain metabolic disorders and other eye diseases.
|
|
|
|
|
| What are the factors affecting Cataract formation? |
|
Heredity: It plays a significant role in the incidence and maturation of senile cataract in families. Irregular diet in regards to proteins, vitamins and minerals has been blamed for early onset of cataract. Exposure to ultraviolet rays has resulted in early onset of cataract.
Sometimes cataract may be present in children. Congenital or developmental cataract occurs due to disturbance in the formation of lens fibres. |
|
|
|
|
| How do I know that I have developed Cataract? What are its Symptoms? |
|
You may have frequent change of glasses, usually a myopic shift (i.e. increase of the minus number and decrease of the plus number) is seen.
Patients feel the need for brighter light for reading and a progressive blurring of vision. They experience glare or haloes from lights at night, difficulty in driving may be experienced. There may also be an altered perception of colours.
|
|
|
|
|
| Why should I get Cataract Surgery done? |
|
| Cataract surgery improves the quality of life by improving the vision of the patient. People resume office work, household chores, computer usage, reading, writing watching television almost immediately after cataract surgery. |
|
|
|
|
| When should I go for Cataract Surgery? |
|
Cataract surgery should be performed as soon as the cataract starts affecting the daily activities of a person. One should not allow the cataract to advance too much as the harder the cataract gets the more difficult the surgery becomes. Unnecessary delay can lead to avoidable complications.
The time of the year have no bearing on the outcome of the cataract surgery. It is safe to get cataract surgery in all seasons summer, winter or rainy season have absolutely no effect on the outcome of the surgery.
|
|
|
|
|
| What should I expect during Surgery? |
|
The surgery requires only few hours stay in the hospital and that also before the surgery for the preparation of the eye.
The surgery is performed under local anaesthesia (Local injection) OR Topical anaesthesia ( i.e. with anaesthetic eye drops). The patient is awake during surgery but does not have any pain or discomfort. Simple instructions given by the surgeon during the surgery are to be followed.
Patients are discharged on the same day.
|
|
|
|
|
| What is Phacoemulsification? |
|
Phacoemulsification is the procedure by which cataract can be removed from the eye using ultrasound energy. Phacoemulsification is not performed with LASER but ultrasound energy contrary to the popular belief. Ultrasound is used to break down (emulsify) the cataract through a very small incision.
The small incision made in phacoemulsification is self sealing and heals very fast. Hence the post operative recovery is very fast as compared to non phaco procedures. One can return to normal work and activities within a few days. This is currently the most effective method for removing cataracts.
|
|
|
|
|
| How is the Phacoemulsification Performed? |
|
The surgery is done using an operating microscope which allows a magnified visualisation of the eye thus allowing microsurgery.
The eyeball is entered through a small incision (2-2.5 mm).
A circular opening is made in the anterior (front part) capsule of the lens. Capsule is the thin membrane that encloses the crystalline lens.
The lens material within the lens capsule is broken (emulsified) using high speed ultrasound waves (40,000 Hz). This broken down lens material is sucked out of the same probe.
Once all the lens material has been cleared a foldable intraocular lens is injected through the small incision and is placed within the remaining portion of the lens capsule. The lens unfolds in the capsular bag and is securely placed there.
|
|
|
|
|
| What is Cold Phaco? |
|
All top-of-of-the-line phacoemulsification machines have the capability to deliver "Cold Phaco". Cold phaco has the advantage of significantly reducing the ultrasonic energy to break up the cataract by delivering the energy much more efficiently leading to a much safer surgery and less damage to the eye.
The WhiteStar Signature with Ellips "Transversal Phaco" is oner such phacoemulsification device, which has made cataract removal a safer procedure.
|
|
|
|
|
| What are the different types of IOLs available and what should I choose? |
|
The aim of cataract is no longer merely visual rehabilitation, but is now aiming to provide patients with the best possible vision and reduce their dependence on glasses for routine activities. There are different types of lenses:
Monofocal IOL: With these IOL implants, the patient has good distant vision but will need reading glasses for near work. These can be with regular or aspheric surface. The aspheric design IOL gives better night contrast. IOLs have undergone a metamorphosis over the last decade with IOLs correcting the spherical aberrations, glare and providing better contrast sensitivity.
Microincision IOL: Microincision IOLs are ultrathin IOLs designed for Microincision cataract surgery.
Multifocal IOL: These IOLs have different optical zones for different distances. They have been designed to give good functional distant, intermediate and near vision. They reduce the patient's dependence on glasses for routine activities.
Toric Lenses: These lenses have rapidly gained popularity for correction of astigmatism. These have cylindrical power incorporated in the lens. They correct the cylindrical power up to 4 dioptres in glasses. These special lenses are used to treat pre-existing corneal astigmatism to reduce patient dependence on glasses post operatively.
Accommodative IOL: Accommodative IOLs (Crytalens) is designed to enable forward movement of the optic components during an accommodation effort.
Your doctor can help you decide which lens is the best for you.
|
|
|
|
|
| What are the problems one encounters with intraocular Lens? How long do the IOLs last? |
|
| Intraocular lenses are very safe. Complications are rare and similar to surgeries performed without IOLs. The IOLs once implanted last a lifetime and do not need to be replaced.
|
|
|
|
|
| Will I need glasses after Cataract Surgery? |
|
| The improvement in vision is dramatic after cataract surgery and most patients do not depend on glasses for their routine daily activities. Some small plus or minus power is however required to attain the best possible visual acuity. Since the calculation of the IOL power is based on certain formulas there may be a person to person variability and a small percentage of patients may have slightly larger power than the others. Furthermore as the intraocular lens are made of plastic and incapable of accommodating (changing shape) for near most patients require glasses for near work.
|
|
|
|
|
| Will I get good vision after Cataract Surgery? |
|
Almost all the patients regain good vision after cataract surgery. The visual recovery is dependent on the condition and functioning of the retina behind.
Corneal scars, vascularisation, ocular surface disorders, diseases of the optic nerve, diseases of the Retina influence the post operative visual outcome. Cataract sometimes does not allow thorough assessment of the Retina and Optic nerve preoperatively.
|
|
|
|
|
| What are the surgical options to treat Cataract? |
|
Surgery is the only treatment for Cataract. Only when the cloudy lens is removed and replaced with an intraocular lens, the light rays are again able to focus on the retina. The early cataracts are however managed with change of glasses till the patient has useful functional vision. The Cataract surgery should be performed as soon as the cataract starts affecting the daily activities of a person. One should not allow the cataract to advance too much as the harder the cataract gets the more difficult the surgery becomes. Unnecessary delay can lead to avoidable complications.
The surgical modalities are:
Extracapsular Cataract Extraction (ECCE): In this procedure the Cataractous lens is removed as one piece. This therefore requires a large incision ( 10-12 mm) and the incision has to be closed with multiple stitches. The visual stability takes much longer and the final glass prescription is given at 6 weeks.
Small Incision Cataract Surgery (SICS): in this procedure the cataract is removed manually through a smaller incision (6-7 mm). It does not require stitches and heals fast. The visual stability takes about 4-5 weeks.
Phacoemulsification is a Microincision cataract surgery by phacoemulsification requiring a very small incision (about 2 mm). It is a day care procedure requiring about 2 hours in the hospital. It is stitchless and painless. The wound is very secure after surgery and heals very fast. A foldable lens is implanted in the eye at the end of the procedure. The final glass prescription is given in 2-3 weeks
|
|
|
|
|
| What are the possible complications of Cataract Surgery? |
|
The newer developments in the surgical techniques and anesthesia in cataract surgery have made it a very safe and successful procedure.
Some minor complications that can occur include a slight drooping of the eyelid, swelling around the eye, corneal haze, reflections or slight distortion from the lens implant, which are usually temporary. The chances for serious complications are negligible. Possible serious complications include infection, severe inflammation, and hemorrhage.
In a most of the cases these complications can be treated successfully or may resolve on their own with a good final restoration of vision. The above list is however not exhaustive. |
|
|
|
|
| Can Cataract Recur? |
|
| The cataract does not recur . Sometimes there is an after cataract formation due to the opacification/scarring of the posterior capsule over which the the IOL is placed. This leads to slow deterioration of vision and can be easily treated by LASER as an OPD procedure. |
|
|
|
|
| When can I go for the other Eye Surgery? |
|
Both eye surgeries are not done together. Depending on the recovery of first eye, the second eye can be operated even on the next day.. It is dependent on your own comfort.
|
|
|
|
|
