What is cataract?
It is loss of clarity of the natural lens, which prevents light rays from reaching the retina. It might vary from slight grayish discolouration of lens to pearly white or brownish-black coloured lens depending on the stage and type of cataract.In early cases, a simple change in spectacle power may help. However quality of vision may be affected, and can be noticed easily if the cataract is more in one eye.As the cataract progresses, vision drops even with spectacles, till finally only the perception of light remains.
What are the causes of cataract?
Ageing is the most common cause of cataract. Every person gets it sooner or later, especially people over 60yrs of age. Occasionally it can start at a younger age and rarely it may be present even at birth. Other causes include diabetes, eye injury, use of certain medications, and secondary to other eye diseases such as uveitis and glaucoma.
What are the symptoms of cataract?
The most common symptom blurring of vision, which is painless and gradually worsens. Other symptoms include double vision or seeing multiple images, trouble with seeing in dim light and sometimes in excessive sunlight, and becoming sensitive to glare, making night driving difficult. Difficulty in distance vision and in reading are also experienced.
Can cataract be prevented?
There is no scientifically proven strategy to prevent formation of cataract, or its worsening once started. However research suggests that avoiding intense UV light (by wearing protective sunglasses), avoiding smoking, and keeping diabetes in check may help.
What is the treatment of cataract?
Cataracts are treated with surgery if vision problems are interfering with the person's daily activity and quality of life. Cataract surgery is very common and is the most successful and cost-effective surgical procedure worldwide. It involves removing the cataractous natural lens of the eye, and replacing it with an artificial lens called an intraocular lens (IOL) implant.
Cataract cannot be treated medically with oral medicines or eye drops.
When should a cataract be operated?
Although stronger eyeglasses or brighter lighting may help relieve the symptoms of a cataract in its early stages, surgery is the only cure for cataracts. However, just because one has a cataract doesn’t mean that he/she has to have it removed. Cataract surgery only becomes necessary when one is not happy with the vision and there is a desire to see well. Talk to your eye doctor if you have any questions or concerns about your vision.
Will I be unconscious (put to sleep) during the surgery? Is it painful?
With the advent of numbing drops, most of the surgeries can be performed without putting the person to sleep. The person can talk and interact with the doctor during the surgery. The surgery is virtually painless. In very few cases, a small injection may have to be given around the eye to numb it totally.
Type of Surgeries:
Surgery can be performed manually through 5- 6 mm wound called SICS (Small Inscision Cataract Surgery).
Phacoemulsification is at present the universally accepted standard-of-care for cataract surgery.Ultrasound energy is used in phacoemulsification to break up the cataract (emulsify) into microscopic fragments which can be sucked out of the eye.
What is MICS?
The surgical wounds have progressively become smaller and now the latest technique is “Micro-coaxial Phacoemulsification” or MICS.
MICS is phacoemulsification of the cataract through a wound of 2.2 mm or less, with implantation of an intra-ocular lens through the same wound.
Wound healing and refractive stabilization is faster in MICS than in traditional phaco.
Furthermore these lenses are preloaded by the manufacturer into the injector. Thus they can be directly injected into the eye without touching the lens by any instruments.
Is there a choice in the type of lens to be implanted in the eye?
The majority of the IOLs implanted are mono-focal. They can focus light rays from one particular distance only. Normally distance objects are clear and one needs glasses for reading.
Intra ocular lens can be rigid or foldable. The advantage of foldable lenses is that it can be inserted through a smaller wound.
Monofocal Aspheric IOLs
These IOLs additionally correct ‘higher order aberrations’ (especially spherical aberration), which cannot be otherwise corrected by spectacles. This improves the quality of vision and clarity especially in dim light condition.
Multifocal lenses are specially engineered and have different segments built onto the same lens. These segments focus light from both distant as well as near objects, allowing spectacle freedom for most activities.
Traditionally used monofocal IOLs correct only the spherical refractive error. Patients with pre existing astigmatism will need spectacle correction for distance vision and near. Toric IOLs eliminates the need of glasses for distance.
Recently multifocal IOLs have also been introduced with this option, thus correcting for distance, near and cylindrical error.
Toric Multifocal IOLs
Astigmatism is a refractive error in which the curvature of the cornea is different in different meridia. The shape is more akin to an American football rather than a regular football. People with astigmatism were earlier not suitable for multifocal IOLs. Now with the introduction of Toric Multifocal IOLs, it is possible to correct this astigmatism and also provide good near vision tothis group of people.
We at Shobhana Eye Clinic, have one of the most advanced Cataract Management System.
We have always made an effort to acquire the most advanced technology required for Diagnosis, Evaluation and Surgical Management of Cataract.
All patients with Cataract are subjected to various preoperative examinations with the help of following machines.
LENSTAR LS 900: is an Optical Biometer used for measurement of the lenght of the eyeball and corneal curvature. This data is utilised for accurate calculation of the IOL power with use of 4th generation formulas. This is a highly accurate German-made machine which gives very precise readings in a very short time without touching the patient's eye.
ZEISS CIRRUS HD-OCT 500: is a non-contact imaging machine by German company -CARL ZEISS,which is world's leading innovator in OCT technology. This machine provides vital information about retina ,optic nerve and the anterior chamber of the eye which helps in predicting the outcome of cataract surgery.
SHIN NIPPON TOPOGRAPHER: is a Japanese corneal topography machine which gives very vital information of the shape and curvature of the cornea. This is important in precise management of astigmatism with the help of LRI (Limbal Relaxing Incision) or TORIC IOL.
After thorough Preoperative Work up, the patient is posted for Cataract Surgery. The following Advanced Technology machines are used for cataract management.
ALCON INFINITI PHACO MACHINE: is an American state of art cataract management Phacoemulsification Machine with unique OZIL technology. This technology helps in effective emulsification of the hardest of cataract without any collateral damage to the adjacent eye structures especially the cornea. This helps in fast recovery of the patient with excellent post operative outcome.
ZEISS OPMI 1 FR PRO: is a german made surgical LED microscope with the finest optics in the world from CARL ZEISS. This provides the best view of the inside of the eye during surgery.