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Cataract

What is cataract ?

  1. Normal lens is clear and transparent
  2. Light rays easily pass through it
  3. When lens becomes cloudy, light rays are blocked
  4. Over a period of time, vision becomes more dull
  5. If untreated, eventually there is a complete loss of vision

Eye with Cataract - Cloudy Lens Example
Symptoms of Cataract - Foggy Vision
What are the symptoms of cataract ?

  1. Blurred vision-slow, painless and progressive
  2. Vision similar to seeing through a frosted/fogged glass
  3. Images-blurry, yellow, double or multiple
  4. Glare and halos especially at night
  5. Frequent change in glasses
  6. Eye strain and headache not correctable by glasses

Can the cataract reoccur?

  1. No
  2. Patient may develop cloudy vision months or years later due to PCO (Posterior Capsular Opacification)
  3. PCO is treated with YAG laser in OPD with vision recovery within a few hours

Best time to treat cataract

  1. Old concept Cataract has to be mature or ripe to be removed
  2. Present concept-any cataract which hinders day to day activity of the patient, should be removed
  3. Cataract surgery is a surgery of convenience to enjoy life to the fullest

What happens if the cataract surgery is delayed or not done?

  1. If untreated, vision becomes so blurred that patients can not perform even daily routine tasks
  2. Rarely, cataract may become hyper mature (overripe) & burst and can lead to complications like Glaucoma leading to permanent vision loss.

What is Robotic Cataract Surgery?

  1. Special advanced Laser machine called Femtosecond Laser
  2. It prepares the Cataract with precise Capsular opening, accurate cuts in the Cataract and corneal Incisions
  3. Makes surgery precise, easy and safe
  4. Cataract can be easily Emulsified by phaco machine

Causes of Cataract

  1. Common – Ageing or degeneration and Ultraviolet rays exposure
  2. Other – Diabetes, Eye Injury, medication like steroids, infection or inflammation
  3. Images-blurry, yellow, double or multiple
  4. Rarely-congenital (since birth)

Cataract surgery and Recovery

  1. Tiny 2.2 mm micro Incision
  2. Ultrasonic energy
  3. Minimal or No Anesthesia
  4. Vision recovers within a few hours
  5. Rapid recovery within 48-72 hours for professional work
  6. Resume work within 2-3 days

How safe is cataract Surgery?

  1. One of the safest surgery performed world over
  2. Complications are rare, minor and temporary like burning, watering, corneal haze, itching, lid swelling and drooping, floaters, glare and halos
  3. All the above are temporary and recover with healing & medications
  4. Serious complications like infection, Inflammation, nucleus drop and retina detachment are extremely rare with modern Micro Surgery

Options for Intra Ocular Lenses (IOLs)

  1. Natural lens has to be replaced by IOL
  2. Different types of IOLs are – Non-Foldable. Foldable, Hydrophilic, Hydrophobic, Aspheric, Monofocal, EDOF, Trifocal and Toric
  3. Foldable IOLs go through incision of 2.2-2.8 mm
  4. No stitches are required
  5. Faster healing, less chances of Infection and astigmatism
  6. Enhanced quality of vision – High contrast/HD vision

Intraocular Lens Implant Surgery Tools
Types of Cataract Intraocular Lenses (IOL)
Aspheric IOLS

  1. Conventional spherical IOLs less sharp image akin to vision of an older person
  2. Aspheric IOLS-Improves image quality, contrast and brightness
  3. Aberration free and wavefront design-improves low light or night vision
  4. Faster reaction time useful for night driving
  5. Improved depth perception with negatively aberrated lenses

Toric IOLS

  1. Sphericaleye-shaped like a ball
  2. Cylindrical/Astigmatism shaped like an egg. Light passes through it and does not focus sharply on retina leading to blurred image
  3. Toric IOLs correct astigmatism and decrease dependence on glasses

Multifocal/Trifocal IOLS

  1. Monofocal IOLs provide good distance vision but patient will need reading glasses
  2. Multifocal IOLS provide full range of vision from distance to near
  3. Patient may note night glare or halos initially after surgery which lessen after a few weeks
  4. Spectacle free vision

Multifocal and Trifocal IOL Image
EDOF IOL for Extended Range Vision
Trifocal IOLS

  1. Latest Trifocal IOLs allow patient to effortlessly switch between reading, Intermediate and long distance
  2. Required for digital devices like computers
  3. Reduced incidence of glare and halos as compared to Multifocal lenses
  4. Multifocal and Trifocal IOLs are contraindicated in patients with underlying Retina or Cornea pathology

Extended Range of vision (EDOF) IOLS

  1. Two technological advancements-Elongating focus of eye -Correction of chromatic aberrations (colour distortion)
  2. Provide sharp vision in all lighting conditions
  3. Almost no glare or halos
  4. Excellent distance and intermediate vision especially required for computer use
  5. Patient may need a small reading number to read extremely fine prints

Multifocal and Trifocal IOL Image
Other IOLS

  1. Micro Incision IOLS Go through 1.8mm Incision
  2. Accommodative IOLs uses patent’s own accommodation to give range of vision
  3. Heparin and Ozone modified IOLs to reduce chances of inflammation and PCO (Posterior Capsular Opacification)