Cataract

Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibres over time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. Many patients first symptoms are strong glare from lights and small light sources at night, along with reduced acuity at low light levels. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's transparency.

Following surgical removal of the natural lens, an artificial intraocular lens is inserted in the eye. Cataract surgery is performed using local anaesthesia which can be either topical or peribulbar usually causing little or no discomfort to the patient. Day care, high volume, minimally invasive, small incision phacoemulsification with quick post-operative recovery has become the standard of care in cataract surgery all over the world.

DIFFERENT TECHNIQUES FOR CATARACT SURGERY :

  • Phacoemulsification is the preferred method in most cases. It involves the use of a machine with an ultrasonic handpiece equipped with a titanium or steel tip. The tip vibrates at ultrasonic frequency (40,000 Hz) and the lens material is emulsified. Fragmentation into smaller pieces makes emulsification easier, as well as the aspiration of cortical material. After phacoemulsification of the lens nucleus is completed, a dual irrigation-aspiration (I-A) probe or a bimanual I-A system is used to aspirate out the remaining peripheral cortical material. A foldable intraocular lens is then injected from the corneal incision.

  • Micro incisional Cataract Surgery (MICS): In this technique, phacoemulsification is done through an ultra small incision whose size can vary between 0.7 – 1 mm. This technique offers an advantage of ultra small incision.

  • Sutureless Cataract Extraction: This technique is advantageous in cases where phacoemulsification is contraindicated. Although it is a sutureless technique, the size of incision varies upto nearly 5-6 mm.

  • Conventional extracapsular cataract extraction (ECCE): Extracapsular cataract extraction involves the removal of almost the entire natural lens in toto while the posterior elastic lens capsule (posterior capsule) is left intact to allow implantation of an intraocular lens. It involves manual expression of the lens through a large (usually 10–12 mm) incision made in the cornea. Although it requires a larger incision and the use of stitches, the conventional method may be indicated for patients with very hard cataracts or other situations in which phacoemulsification is problematic.

POST-OPERATIVE CARE :


Following surgery, the patient is discharged after a short stay in the outpatient recovery area.

The patient is advised to administer eye drops, as prescribed by the surgeon, several times daily during the next few weeks.

The patient can wear sun shades to help protect the eye in bright light.

During the first week of recovery, it is essential that the patients should avoid:

  • Strenuous activity and heavy lifting
  • Bending, exercising and similar activities that might stress the eye while it is healing.
  • Water that might splash into eye and cause infection. Keep your eye closed while showering or bathing. Also, avoid swimming or hot tubs for at least two weeks.
  • Any activity that would expose your healing eye to dust, grime or other infection-causing contaminants.

Always follow your surgeon's specific instructions, which you will receive prior to your discharge from the outpatient department.