Lens is a structure in the eye which is responsible for focussing the light on the retina. Opacities occurring in the lens are called as cataract. Cataract formation is a natural part of the ageing process. It may occur due to injury or may be present at birth, but the most common cause is related to age (Senile Cataract) and is the leading cause of reversible blindness in India.
Modern day cataract surgery includes not just removal of cataract but also correction of refractive error with the option of spectacle freedom after surgery. The state-of-the-art facilities available at PBMA’s H.V Desai Eye Hospital include high end Biometry & Operative Planning modules, Phacoemulsification systems & Operating Microscopes which enable us to perform Phacoemulsification (Micro incision suture less surgery) and Small Incision Cataract surgery.
Facilities for cataract surgery
- Biometry machines – Zeiss IOL master, Haag Streit Lenstar, Pentacam
- Operative planning modules – Alcon Verion – only centre in Pune having this machine – Pre-operative photograph and data of the eye to be operated is measured and surgical procedure planned by the vision planner module. This data is then transferred to the operation theatre where the operating surgeon sees the data overlay in the surgical microscope and accordingly surgery can be performed optimally.
- Operating microscopes – Zeiss Lumera & 1 FR Pro
- Advanced phacoemulsification machines including Alcon Infiniti, Zeiss Visalis, AMO Compact Sovereign
- Toric IOL – for correcting pre-existing astigmatism
- Multifocal IOL – IOLs optimised for distance as well as near vision for spectacle free vision after cataract surgery
- Zeiss YAG laser for treating posterior capsular calcification occurring after cataract surgery
Premium IOL options available are Aspheric IOLs, Aspheric Hydrophobic IOLs, Toric IOLs and Multifocal IOLs from the leading IOL manufacturing companies in the world including Alcon, Rayner, Technis etc.
All types of cataract surgeries including refractive cataract surgeries (Toric & Multifocal IOLs) and complex cataract surgeries are performed by competent and experienced surgeons. Almost all the cataract surgeries are performed using phacoemulsification technique. Surgical options are also available for complicated cataract patients including Iris claw IOLs, Scleral fixated IOLs & Glued IOLs. Facilities for Cataract surgery combined with other surgeries like Corneal transplantation surgery, Glaucoma surgery and Vitreoretinal surgeries in the same sitting are also available.
- Premium pain-free experience, dedicated & focussed services with personal care
- Topical anaesthesia – No injection, no patch surgery
- General anaesthesia facility also available for surgeries
- Ongoing research projects for further improved surgical outcomes and patient experience
- Cataract surgery for one & all
INFORMATION FOR PATIENTS
A cataract ( motibindhu) is a clouding of the eye's natural lens, which lies behind the iris and the pupil. It is the normal aging process in the eye.
Cataracts are the most common cause of vision loss in people over age 40 and is the principal cause of blindness in the world. In fact, there are more cases of cataracts worldwide than there are of glaucoma, macular degeneration and diabetic retinopathy combined.
Types of cataracts include:
- A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
- A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with aging.
- A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
Cataract Symptoms and Signs
A cataract starts out small and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting.
A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colours may not appear as bright as they once did.
The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called "second sight."
Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may not produce any symptoms until it's well-developed. Subcapsular cataracts may cause a lot of glare and discomfort from headlights of vehicles at night.
If you think you have a cataract, see an eye doctor for an exam to find out for sure.
What Causes Cataracts?
The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye's focus, letting us see things clearly both up close and far away.
The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.
But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.
No one knows for sure why the eye's lens changes as we age, forming cataracts. But researchers worldwide have identified factors that may cause cataracts or are associated with cataract development. Besides advancing age, cataract risk factors include:
- Ultraviolet radiation from sunlight and other sources
- Prolonged use of corticosteroid medications
- Statin medicines used to reduce cholesterol
- Previous eye injury or inflammation
- Previous eye surgery
- Hormone replacement therapy
- Significant alcohol consumption
- High myopia
- Family history
One theory of cataract formation that's gaining favour is that many cataracts are caused by oxidative changes in the human lens. This is supported by nutrition studies that show fruits and vegetables high in antioxidants may help prevent certain types of cataracts (see below).
Though there is significant controversy about whether cataracts can be prevented, a number of studies suggest certain nutrients and nutritional supplements may reduce your risk of cataracts. Higher dietary intakes of vitamin E and the carotenoids lutein and zeaxanthin from food and supplements may decrease risk of cataract.
Another step you can take to reduce your risk of cataracts is to wear protective sunglasses that block 100 percent of the sun's UV rays when you are outdoors.
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids.
With the newer surgical techniques available today one does not need to wait for the cataract to mature fully. Think about surgery when your cataracts have progressed enough to impair your vision and affect your daily life.
Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain vision.
Cataract surgery –
Catarct surgery is now a short and painless procedure during which the surgeon will remove your clouded lens and replace it with a clear, artificial intraocular lens (IOL) of the appropriate power.
Cataract surgery is not just removal of cataract but also correction of refractive error for distant and near vision. Also provides option of spectacle freedom after surgery. New IOLs are being developed all the time to make the surgery less complicated for surgeons and the lenses more helpful to patients. Presbyopia-correcting (Multifocal) IOLs potentially help you see at all distances, not just one. Another new type of IOL blocks both ultraviolet and blue light rays, which research indicates may damage the retina.
Cataract surgery can be done under anaesthetic drops (no injection). However, some patients may require injection of anaesthetic near the eye. The patient feels no discomfort and is advised to lie still for the duration of the surgery.
The cataract is removed through a very small incision using a phacoemulsification instrument which breaks up the cataract using ultrasonic waves. The cataract is then sucked out of the eye. The cataractous lens is then replaced by a suitable artificial foldable lens injected through the small incision.
The surgery is performed in a sterile operating theatre using complete aseptic precautions. The surgery will be performed in 20-30 minutes.
Advanced refractive cataract surgery is available at this hospital:
Advanced machines for accurate measurement and surgery
Biometry machines – for accurate IOL power calculations
Zeiss IOL master, Haag-Streit Lenstar, Oculus Pentacam (Put photographs)
Operative planning modules – Verion – only centre in Pune having this advanced machine (Put photographs) –
Pre-operative photograph and data of the eye to be operated is measured and surgical procedure planned by the vision planner module. This data is then transferred to the operation theatre where the operating surgeon sees the data overlay in the surgical microscope and accordingly surgery can be performed optimally.
Advanced phaco-emulsification machines from Alcon, Zeiss, AMO
Toric IOL – for correcting pre-existing astigmatism
Multifocal IOL – for spectacle free vision after cataract surgery
Toric multifocal IOL – for spectacle free vision in individuals with pre-existing astigmatism
Premium pain-free experience, dedicated & focussed services with personal care
Topical anaesthesia – No injection, no patch surgery
General anaesthesia facility also available for surgeries
Ongoing research projects for further improved surgical outcomes and patient experience
Surgical options are also available for complicated cataract patients:
- Iris claw IOL
- Scleral fixated IOL
- Glued IOL
Cataract surgery for one & all.
EYECARE AND PRECAUTIONS AFTER SURGERY
- Do not rub the eyes
- Do not sleep on the side of the operated eye
- Avoid head bath for ten days
- Wear protective eye glasses
- Put drops as indicated by your doctor
- Avoid strenuous exercises
- To review as per directed by your doctor
REPORT BACK IMMEDIATELY IF YOU HAVE THE FOLLOWING SYMPTOMS
- Redness of eyes
- Decrease in vision
- Pain in the eye
- Excessive watering
- Discharge from the eye