Cataract Services

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).

Cataract formation is not associated with warning "signals" such as pain, redness or tearing. The common symptoms are:

                

TREATMENT OF CATARACT:-

Surgery is the only treatment for cataract. It involves removal of cloudy cataractous lens along with implantation of Intraocular Lens(IOL) There are two types for cataract surgery:



Conventional Cataract surgery or Extra Capsular Cataract Extraction (ECCE)

Here, whole cataractous lens is removed in one piece and Rigid/Non-foldable IOL in implanted inside eye.


It requires:

Injections near the eye- causing pain Long incision of 10-12mm- which need to be stitched. Final glass prescription could take even upto 10 weeks


Modern Stitchless Cataract Surgery using PHACOEMULSIFICATION

Here, Cataractous lens is liquidified and aspirated with the help of Phacoemulsification system. It is followed by foldable IOL implantation in eye. It requires a very small incision of 1.8 - 2.8mm Smaller incision helps by Eliminating the need of injection Eliminate the need of sutures Minimum post surgery precautions Quicker healing and recovery.



PHACOEMULSIFICATION TECHNIQUE

It involves:

INTRAOCULAR LENS(IOL)

Types of IOL:




Used in Conventional Cataract Surgery

Used in Modern Cataract Surgery with Phacoemulsification

These IOLs give better quality of vision post operatively due to the aspheric lens design which greatly reduces chromatic aberration. It increases contrast and decreases glare.

These IOLs correct the astigmatism due to their toric surface. High preoperative astigmatism is an indication for Toric IOL implant.

These IOLs reduce the dependence of patient on glasses for near vision. However some patients may experience excessive nighttime glare post operatively but usually they get adapted within a few months.

Cataract Services

At Brar Eye Hospital, modern stitchless cataract surgery is performed with Phacoemulsification technique in all types of cataracts. All types of IOLs like Aspheric, Toric, Multifocal,accomodative etc. are implanted as per patient need.We have AMO’s Whitestar Signature Phacoemulsification system. This is the latest phaco system available in the market and handles all types of cataracts well.

Advantages of Whitestar Signature

The Signature Advantages

Signature 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. Brar Eye Hospital has opted for the latest technologies in phaco keeping in mind the extraordinary procedural safety it offers.

Why at our center?

Brar 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. BEH is an icon of dynamic progress in the field of Ophthalmology. The hospital has the distinction of being the First Eye hospital in North 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

We have
  • AMO’s Whitestar Signature- World’s one of the best Phacoemulsification system
  • Carl Zeiss Lumera Operating Microscope- Better microscope means better visualization of procedure which decreases the complications.
  • IOL Master- Most accurate IOL power calculating device in the world so far. This increases predictability of postop. Vision
  • Immersion biometry with A scan- To accurately calculate IOL power in very dense cataracts
  • Nidek’s portable keratometer for children and debilitating patients.
  • Carl Zeiss Visualis Nd YAG laser system for removing opacification of membrane behind IOL.
  • Topcon’s AutoKeratorefractometer for accurate post op. prescription of glasses.
  • B scan for evaluation of retina in very dense cataracts


Moreover, our OT is equipped with certified laminar flow system(to prevent infection), Full Life support system including ventilator, defibrillator etc.During surgery each case is under care of experienced anesthetist. NABH certification means all patient safety procedures defined by NABH like regular culture, humidity maintenance etc are strictly followed.

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.

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
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.

How is Phacoemulsification surgery done?

Cataract surgery is performed on an outpatient basis, and usually requires just a few hours of your time from start to finish. Your eye will be treated with anesthetic prior to the procedure so you'll feel little, if any, discomfort. First, a tiny incision will be made in the eye allowing your surgeon to use a small instrument (about the size of a pen tip) to break up or wash away the cloudy cataract. Once the cataract is removed, and the IOL will then be inserted through the same tiny incision and set into its permanent position.

What are the advantages of phacoemulsification with foldable IOL over conventional cataract surgery ?

It allows for a injectionless, stitchless, painless, no bandage surgery
Drops of local anaesthetic 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 for distance only to fine -tune your vision which varies from person to person This number usually depends on the shape of cornea what is usually called corneal astigmatism. 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.

Is phacoemulsification safe?

In the hands of a good surgeon phacoemulsifiaction is extremely safe due to these advantages:

Small self sealing incision (1.8 to 2.8mm):

Sutures are not needed due to the very small incision. This reduces the risk of astigmatism and foreign body sensation after surgery.

Topical Anesthesia

Anesthetic eyedrops is all what is required. No need for injections or general anesthesia.

Immediate recovery

No admissions to the clinic or bandages are needed. The patient may restart daily activities immediate Just as any other surgical procedure, phacoemulsification has risks. One out of a hundred persons operated on with this technique has some sort of complication. In almost every case there is a solution to the problem. Severe complications are extremely rare.

Who will benefit from phacoemulsification?

Most people suffering from cataracts will benefit from this procedure. Best results are obtained in persons with early cataracts. It is preferable not to wait until the cataract is ripe and vision is excessively low since the cataract will be too hard for the phacoemulsifier. Surgery is indicated as soon as vision is not adequate for daily activities.

Do I have to undergo any investigations before surgery?

Your ophthalmologist will make sure there are no associated pathologies, which can interfere with the prognosis, by making an extensive examination of your eyes including pupil dilatation. A measurement of your eye's length and corneal curvature is crucial for calculating the power of the intraocular lens to be implanted. Systemic examination includes tests like blood sugar ,blood pressure examination, ECG etc.

What should I do during surgery?

During surgery you will be lying on the operating bed. The operating microscope will be in front of you and you will always see the microscope's bright light. Your face will be covered with sterile drapes. You should never touch these drapes. A small device will hold your lids open. During the procedure you should keep your eye as still as possible. Usually looking at the operating microscope's light is a good reference point. You will feel the hands of the surgeon on your forehead and the sound of the phacoemulsifier, similar to that of a hair trimmer. You will occasionally feel cold water over your eye that may even go down your cheek. This is the solution needed to keep your eye properly hydrated.

Is phacoemulsification painful? How long does it take?

Phacoemulsification is performed under topical anesthesia (anesthetic eyedrops). No injections or general anesthesia are required. The patient is awake during the procedure usually feeling no discomfort but might feel some pressure sensation you will feel have a feeling of some water falling on the eye but this is not harmful .Phacoemulsification takes about 10 minutes per eye. Once finished, you will go home without need for hospitalization.

What care should i take after surgery?

Do not rub the operated eye
Do not sleep on the operated side for 3-4 days
Use dark glasses for first 15 days
Wash your hands thoroughly before application of drops