What is Cataract ?

A cataract is an opacity or cloudiness in the natural lens of the eye. It is still the leading cause of blindness worldwide. In India it is commonly known as Safed Motia. When the lens is partially opaque, it is called an immature cataract and some light can pass through to help perform some routine functions. However, when the opacity increases to engulf the entire lens, vision is totally cut off and the cataract is mature.

What are the problems associated with Cataract ?

Just as a smudged or dirty camera lens may spoil a photograph, opacity in the natural lens of the eye can result in a blurred image. Patients with cataracts usually complain of blurred vision either at distance, near, or both. This may interfere with tasks such as driving or reading. Other common complaints include glare, halos, and dimness of color vision. However, none of these symptoms are seen exclusively in cataract. Initially some help is achieved by changing the spectacle number, but in advance cases the spectacles also prove to be ineffective.

What are the causes of Cataract?

The development of cataracts in the adult is related to aging, sunlight exposure, smoking, poor nutrition, eye trauma, systemic diseases, and certain medications such as steroids.

What should one do?

The first thing a person must do on experiencing any of these symptoms is to consult an eye surgeon (Ophthalmologist) giving details of ones symptoms and getting ones eyes thoroughly examined. Answers to the following questions should be sought.

What is the treatment for Cataract?

There are no medicines to treat cataract. The answer lies only in surgery where the cataract is removed and replaced by an intra-ocular lens.

What is Phaco Technique?

Cataract surgery today is typically performed using a micro-incisional procedure called Phaco-emulsification. To the patient, this means minimal discomfort during or after surgery, a more speedy recovery of vision, and reduced risk of induced astigmatism. This means less dependence on glasses afterwards. It is typically done through an incision about 3 millimeters in size – just about one-eighth of an inch! Because of the careful construction of this incision, and its small size, the incision is generally self-sealing. This translates to a “no-stitch” type operation. Phaco needle is introduced through the opening and ultrasonic vibrations are used to break the cataract into smaller fragments which are sucked out through this needle. An artificial lens called a foldable Intra-Ocular lens is now injected through this small opening. Once inside the eye, it opens up and serves to replace the original lens.

How is this technique better than conventional technique?

The main advantages of Phaco are that a person has a good vision the very next day and may resume routine activities also the very next day. Stitches and related problems are things of the past. A person may now accomplish routine activities without spectacles, however a little spectacle correction may be required for fine focusing for distance and near.

What to Expect After Surgery ?

The great majority of patients may resume normal activities on the day of or day after surgery. Though the best vision may not be obtained until several weeks following surgery, but individual results vary considerably, depending on many variables. Activities such as reading, watching television, and light work will not hurt the operated eye. Most surgeons arbitrarily recommend waiting 4 to 6 weeks before new glasses are prescribed. This allows the eye to achieve considerable stability from a refractive standpoint and, therefore, the glasses prescription should be accurate and relatively stable. Many patients are surprised at how clear their vision is after cataract surgery. Some patients may have better vision than they ever did before cataract surgery. Furthermore, depending on the degree of refractive error (need for glasses) prior to surgery, many patients will be much less dependent on glasses for far vision than they were before surgery. Patients will often notice that colors are brighter and more brilliant.

Is this technique more expensive than conventional stitch technique?

Hi-tech expensive equipment and special lens other expensive material are required to execute a good surgery, making it a little more expensive than the conventional technique.

Can an immature cataract be operated by Phaco?

Yes.

What are the type of lenses implanted after cataract surgery?

Foldable Lens: This lens has a diameter of 6.0 mm and is made of either Silicon or Soft Acrylic. On folding, it's diameter is reduced to 2.75 mm and it can be introduced into the eye through a 3 mm incision, where it unfolds automatically to take it's position. The main advantage of this lens is that there is fast visual recovery in the patient.

Non-foldable Lens: This lens has a diameter of 5.5 mm. A 3 mm incision has to be enlarged to 5.5 mm to introduce this lens. However, the incision still remains self-sealing and requires no sutures in most of the cases.

Aberration Free Foldable Lens: This lens is like a foldable lens in all ways, except that it’s an aspheric lens. It reduces glare in the patient and is very useful for the patients who would like to drive at night.

Multifocal Lens: This is also a type of foldable lens which has distance as well as the near power in it. After it’s implantation, patients will become much less dependent on glasses for near as well as distance. However, if you have cylindrical power in your glasses, you may need corrective lenses for fine work.

Toric Lens: This is also a type of foldable lens which has cylindrical power in it so that you do not need any glasses for distance vision after the surgery.

Toric Multifocal Lens: This is also a type of foldable lens which has distance as well as the near power along with cylindrical power in it. After it’s implantation, patients will become much less dependent on glasses for near as well as distance. However, if you have cylindrical power in your glasses, you may need corrective lenses for fine work.

What investigations are required before performing this procedure?

The Blood Pressure (BP) and Blood Sugar should be in control.
E C G and a medical checkup may be required in some cases.

Will I need to use glasses after Phaco?

The lens that we use is a fixed powered lens. This is focused between the distance and the near vision more so for distance as this is the vision that is in use most of the time. As a result a person after the Phaco procedure will be able to perform routine activities without glasses. However a little spectacle correction would be required for fine focusing of distance and near vision.

What is the cost of Phaco?

With a non foldable lens: Rs.10,000/- per eye
With a foldable lens: Rs.16,000 - Rs.28000/- per eye
Microphaco with foldable lens: Rs.30,000 - Rs.32000/- per eye
With a multifocal lens: Rs.55,000/- per eye
With multifocal Toric lens: Rs.70,000/- per eye