Lens, is a structure in the eye, which is responsible for focusing the light on the retina. Opacity occurring in the lens is called cataract. Cataract formation is a natural part of the aging 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 freedom from spectacles 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 – IOL's , 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 & focused 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 enhanced 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 a normal aging process in the eye.
Cataract is the most common cause of vision loss in people over the age of 40 years and is the principal cause of blindness in the world. In fact, there are greater number of cataract cases worldwide than the combined cases of glaucoma, macular degeneration and diabetic retinopathy.
Types of cataracts include:
- A sub-capsular 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 sub-capsular 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 opacity that starts in the periphery of the lens and works 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.
Due to cataract, light from the sun or a lamp may seem too bright or glaring. While driving at night, one may notice that the incoming headlights from another vehicle, cause more glare than before. Different colors, may not appear as bright as they once did.
The type of cataract one has, will give out signs and symptoms, specific to its characteristics and duration. When a nuclear cataract first develops, it can bring about a temporary improvement in one's near vision, called 'second sight.'
Unfortunately, the improved vision is short-lived and will disappear as the cataract advances and worsens. On the other hand, a sub-capsular cataract may not produce any symptoms until it is well developed. Sub-capsular cataracts experience discomfort from headlights of vehicles at night.
In the situation, wherein one experiences such signs and symptoms or cannot see well, have an inkling tht one may have developed cataract in ones eye, one must consult an ophthalmologist, for an exam to find out for sure and take necessary treatment, as prescribed by the ophthalmologist.
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 difficult to see properly.
No one knows for sure why the lens of the eye changes as we age, thereby forming cataracts.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, which is gaining favor is that many cataracts are caused by oxidative changes in the human lens. This theory, is supported by nutrition studies which show that consumption of fruits and vegetables, which are said to be high in antioxidants, may help prevent certain types of cataracts (see below).
Though there is major controversy about whether cataract can be prevented, a number of studies suggest consumption of certain nutrients and nutritional supplements which may reduce the risk of development of cataract. Higher dietary intake of vitamin E and the carotenoids lutein and zeaxanthin from food and supplements may decrease risk of cataract.
Another step one can take to reduce risk of cataract is to wear protective sunglasses that block 100 percent of the UV rays emitted by the sun, when one is outdoors.
When symptoms begin to appear, one may be able to improve ones vision, for a while, by using new glasses, strong bifocals, magnification, having appropriate lighting or other visual aids.
With modern surgical techniques available today, one does not need to wait for the cataract to mature fully. One can go in for surgery, when the cataract has progressed enough, to impair ones vision and affect ones daily life.
Many people, consider poor vision as an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain lost vision.
Cataract surgery –
Cataract surgery, is now a short and painless procedure, during which the surgeon will remove the clouded lens and replace it with a clear, artificial intraocular lens (IOL) having the appropriate power.
Cataract surgery is not just removal of cataract but also correction of refractive error for distant and near vision. It also provides the option of freedom from spectacles after surgery. New IOL's are being developed, constantly, to enable the surgery to be less complicated for surgeons and the lenses to be more useful to the patients. Presbyopia-correcting (Multifocal) IOL's potentially help one see at varying distances, not just one distance. Another new type of IOL ,blocks both ultraviolet and blue light rays - which research indicates may be the cause of damage to the retina.
Cataract surgery can be done under anaesthetic drops (no injection). However, some patients may require anaesthetic injection near the eye. The patient does not experience discomfort and is advised to lie still for the duration of the eye 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 can be performed within 20-30 minutes.
Advanced refractive cataract surgery is available at this hospital:
Advanced equipments, for accurate measurement and surgery.
Biometry machines – for accurate IOL power calculations
Zeiss IOL master, Haag-Streit Lenstar, Oculus Pentacam.
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