What is cataract:-
Cataract is the clouding of natural lens of eye. Most people aged 50 yrs or older have cataract or are likely to get them. Sometimes cataract can also occur in children and younger individuals.
When Cataract causes vision to get blurred, it is better to have the cloudy lens removed by an operation and replaced by a clear artificial lens.
Cataract is not caused by eye strain or reading too much, but is a result of aging, injury, steroid use, exposure to UV light, smoking & diabetes.
Symptoms of cataract.
• Cloudy, fuzzy, foggy, or filmy vision.
• Changes in the way you see colors.
• Problems driving at night because headlights seem too bright.
• Problems with glare from lamps or the sun.
• Frequent changes in your eyeglass prescription.
• Double vision
How to decide when you need cataract surgery?
Most people have plenty of time to decide about cataract surgery. Your doctor can help make your decision with you Tell your eye doctor how your cataract affects your vision and your life. If doing routine things like watching T.V, Driving, reading etc become difficult, you might require surgery. In this era of advanced technology, living with poor vision due to cataract is a matter of choice. You can start seeing well within a few days of cataract surgery.
The Surgery -Phacoemulsification
Using advanced surgical techniques of Phacoemulsification, the removal of the cataract is a safe and straightforward process. It is performed without sutures through a micro incision in the eye and takes 8 to 15 minutes.
This technique is the most successful method of restoring your vision following cataract surgery
How is Cataract Surgery done?
The best way to treat your cataract is to remove the cloudy lens and replace it with a new, clear artificial lens. This can be accomplished two ways. The first and older technique, called extra capsular cataract extraction (ECCE), involves removing the cloudy lens in one piece. This technique requires a large incision of 10 to 12 millimeters in length. This was the older method, requiring rest and care unto a month in most cases.
The second technique is the latest advance in cataract removal. It"s called phacoemulsification, or phaco. In phaco surgery, a small ultrasonic probe is inserted into the eye. This probe breaks (emulsifies) the cloudy lens into tiny pieces and gently sucks it out This lens is then replaced with a clear artificial one. The new lens is inserted and it opens up like a flower when inside. No stitches are used and the incision is self healing. Phaco requires a small incision of only 2.75 millimeters or less.
This technique is most success full method of restoring your vision following cataract surgery.
No discomfort is experienced during and none or minimal after the procedure.
The Lenses used in Surgery and Benefits of Various Lenses.
Once the cataract is removed, a permanent, artificial lens, called an intraocular lens or IOL is implanted. There are two types of IOLs available; non-foldable and foldable. Non-foldable IOLs are made of a hard plastic material, are bigger in size and bigger incisions need to be made to insert them. Foldable lenses are made of a soft acrylic material. They can be inserted through very small incisions .They are ideal for cataract surgery by Phaco.
Foldable Lenses: There are different IOL options available -- Monofocal and Multifocal lenses. Monofocal Lenses are designed to provide patients with good distance vision but typically patients still require the use of glasses for near vision. Multifocal lenses also called Bifocal Lenses are designed to provide patients who have a strong desire for greater independence from glasses or contacts with multifunctional vision. So if you had a Multifocal Lens, you would not need reading glasses and have great distance vision too.
Multifocal Lenses after Cataract Surgery give you the option of greater independence from glasses for a wide range of vision including distance, near and intermediate vision. In most studies 90% and above individuals do not need glasses after multifocal implant.
Dr kamdar uses some of the most advanced Multifocal lenses, Tecnis & Rezoom (AMO, USA), Zeiss and from Bausch & Lomb and many more.
Helping You Choose the Best Lens Implant
In the past, the choice of which type of lens implant to have was really made by the cataract surgeon. That"s because there really weren"t any options for patients. All lens implants were Monofocal. A monofocal lens implant provides excellent vision after cataract surgery-but only at one set distance-usually for seeing things at a distance. This means for seeing distant signs when driving, going to a movie etc,a monofocal lens implant will provide the vision you need to see clearly. But with a monofocal lens implant you will need to wear glasses for any type of near vision activity-for example reading, knitting, sewing, playing cards or ordering from a restaurant menu.
Today, a Specialist cataract surgeon is able to offer you the choice of Multifocal lenses. A multifocal lens implant provides excellent vision after cataract surgery at a variety of distances. Multifocal lens implants correct both your distance vision and your near vision after cataract surgery. For the vast majority of patients, having a multifocal lens implant means that you will be able to see at distance and up close without being dependent on glasses. So, patients choosing to have a multifocal lens implant will likely find that they can drive, watch T.V , work on a computer and read without the need for glasses.
Thanks to the latest Multifocal Lenses, you now have the opportunity to regain Younger Vision again.
Toric IOL - is an astigmatism correcting Monofocal acrylic foldable IOL which is rotationally stable in the eye . The power of IOL is calculated using the Toric Calculator which ensures precise astigmatic correction .
Visual Acuity Assessment
Direct / Indirect Ophthalmoscopy
IOP measurement (applanation tonometry / pneumotonometry)
IOL power measurement (immersion a-scan / laser interferometry)
Specular microscope assessment
Potential Acuity Meter
Examination by Anaesthetist
COUNSELLING BY OPHTHALMOLOGIST OR COUNSELOR : Details of the surgical strategy for standard and complicated cataracts, the post-operative outcomes and most importantly the IOL options are explained to the patients and their attendants
SURGICAL PROCEDURE :
Torsional (ozil)Phacoemulsification With IOL Implantation In The Presence Of A Team Of Anaesthetists
POST-OPERATIVE COUNSELLING :
IMMEDIATE POST-OPERATIVE COUNSELLING is done by consulting counselor regarding eyedrops instillation , sleeping posture ,diet,precautions to be taken post-operatively and resumption of routine activities.
FIRST POST-OPERATIVE DAY EXAMINATION is done by ophthalmologist by slit-lamp biomicroscope followed by counselling.
FOLLOW-UP PROTOCOL involves slit – lamp examination , refraction and fundus evaluation followed by examination by consulting ophthalmologist.
Taking Care after Surgery: You will be permitted to go home just after surgery. You may go home and rest. Eye drops will be advised and are to be started from the evening after surgery. There is no Diet Restriction
- Playing with children is to be avoided for a few days.
- Do not rub the eye with hand or hankerchieves.Use only tissues which can be used and thrown away. This prevents infections.
- Head Bath is permitted after 3 days of surgery.
- If the eyes need to be kept clean after surgery, they should be wiped with cotton dipped in boiled and cooled water.
- Hands should be washed with soap and water before putting the eye drops.
- All activities at home are allowed from next day, including reading, writing, watching TV, Cooking and taking an evening walk in non crowded areas.
PRE-PROCEDURE EVALUATION :
Patients are advised to get a retinal evaluation before the procedure.
The patients need to take prior appointment of a Senior Consulting Ophthalmologist
POST-PROCEDURE INSTRUCTIONS :
Are given by a Senior Consulting Ophthalmologist and patients are advised a repeat retinal evaluation 15 days after the procedure.