Important:Dr Manish Malhotra (Consultant Ophthalmology ) shall not be available on 25December 2017. Please do not schedule appointments during that time. Can take appointments from Tuesday 5.30pm
Cataract Surgery

Cataract formation is a natural part of the eye's aging process. Cataract surgery is a common procedure; most regain the vision they had earlier with the help of microsurgery. The procedure has a 98% success rate. There is very little discomfort or inconvenience and patients can usually return home few hours after surgery, as it is a day care procedure

What is a cataract?

Anything you see is an image that enters your eye in the form of light. Inside your eye is a lens, much like the lens of a camera. Though lens focuses the light rays coming through the pupil onto the retina at the back of the eye. The retina collects this light and sends a message to brain, enabling us to see. For perfect vision the lens should be clear so that light can pass through it and reach the retina. When the lens becomes cloudy or opaque, light cannot pass through it and the vision becomes dim and blurred. This cloudy lens is called a cataract.

Causes of cataract

The most common cause of cataract is the denaturizing of the normal structure within the lens of the eye with age. The other causes like diabetes, kidney disease, glaucoma, smoking, eye injuries, infection, and inflammation inside the eye. Prolonged use of certain medications can also hasten cataract formation. In the early stages, you can improve your vision by changing your glasses. But once the cataract progresses, changing glasses does not help. There is some deterioration to see things clearly from a distance. One may have difficulty with glare while driving, or while performing activities. A cataract may develop slowly over several years or rapidly within months. Often the other eye will also be affected, but it may happen at the same time. There are no medications, eye drops, or dietary restrictions that can cure or prevent cataract formation. If the cataract interferes with your regular activities, the only solution is surgery. There is a possibility that the cataract develops at birth, due to various causes called as congenital cataract , in this also the goal of treatment is early surgery, because for the development of vision the visual axis has to be clear In cataract surgery your natural clouded lens is replaced by an artificial intraocular lens (IOL), which helps to focus the incoming light rays properly.

Surgical techniques

Phacoemulsification ( Also wrongly called as Laser cataract surgery) : In this method a tiny instrument is inserted through a very small incision. The instrument uses ultrasound vibrations to break the cataract into fine pieces, which are gently suctioned out. The new lens is then inserted into the eye. Usually no stitches are required to close the incision. This minimal surgery allows faster and safer healing, hastening your return to normal activity. Small Incision Cataract Surgery (SICS): This is a new technique where the cataract is removed through a small Incision. The small incision heals fast, enabling you to recover quickly. Extracapsular extraction: Here the lens is removed in a single piece through a relatively larger incision. It is replaced with an artificial lens and the incision is closed with tine stitches. The surgeon may opt for this technique in cases where the cataract is very advanced. The recovery period is longer here. Your doctor will select the method of surgery that is most suitable for your cataract.

Planning for surgery

It is not necessary for the cataract to mature fully or for the vision to become totally cloudy before scheduling surgery. You and your ophthalmologist should jointly decide on the time for surgery. Be sure to inform your doctor about any medications or herbal remedies that you may be using. At the Institute our counselors will help you to understand the pre-operative procedures and arive at an estimate of the expenditure involved. Prior to surgery, you will need to undergo some routine medical and blood tests. If you wear glasses or contact lenses bring them so that your prescription con be checked. An A..scan will help the doctor to determine the power of the new lens to be implanted in your eye. It is good to wash your face thoroughly wilh soup curl water before coming for surgery. You will be advised to run some eye drops. Please follow the instructions carefully as thuu drops help dilate your eye. If your eye is not properly dilulod, urirgory may be delayed. You may also be advIsed not to oet or drink anything for a few hours prior to surgery. You curt luing unly one attendant; children below 15 years are no? rillowed unless they are patients.

Be alert for problems

If you have persistent discomfort or pain, and if the pain is severe, inform the Institute or cataract an ophthalmologist immediately. Watch out for these symptoms and if they last more than 24 hours, contact us immediately. Do not delay.

  • Watch out for these symptoms and if they last more than 24 hours, contact us immediately. Do not delay.
  • any sudden change in vision or blurring of vision
  • increase in sensitivity to light or seeing flashes of light
  • increase in redness
  • swelling of the eyelid or bleeding
  • nausea or vomiting
  • a white or cloudy cornea or pupil

Secondary cataract

Blurred vision, months or years after cataract surgery, leads to the mistaken assumption that the cataract has grown again. This is not a cataract but the clouding of the thin capsular bag membrane that helps keep the lens implant in place. To restore clear vision surgeons use a laser (called as YAG Laser) to open a visual path through the cloudy membrane. This is a simple procedure and is done on an outpatient basis. No stitches or surgery are needed. Your vision should improve soon after the laser treatment. Though the success rate for cataract surgery is almost 98%, sometimes there may be complications. Most of these complications are minor and can be rectified.

The surgery

In the operating room, the area around your eye will be cleaned thoroughly. Sterile drapes will be placed around your head and face, with only the eye exposed. Usually a local anesthetic in the form of drops (in case of topical anesthesia)or an injection is administered. An oxygen tube will be placed near your nose so that you do not feel suffocated. The actual surgery lasts about 30 minutes. You will be relaxed and awake but feel no pain. The nerves in your eye will be completely numbed so you will not be able to see or move your eye. Generally, there is very little bleeding.

Care after surgery

After surgery a bandage or shield will be placed over your eye. You will be advised to rest till you are ready to leave. You should wear protective glasses or an eye shield in the day and an eye patch at night to avoid accidental injury. The doctor will advise you when to discontinue them. You can bathe carefully from below your neck but do not wet the operated eye for 15 days. You may gently clean the eyelids with a piece of cotton boiled in water or a sterilized tissue.

Some important Tips

  • Do not rub the operated eye.
  • Do not use any eye cosmetics until the doctor allows it.
  • Do not wash your hair until the doctor says you can.
  • Shave carefully, soap or water should not enter the eye.
  • Avoid any vigorous activity.
  • Do not lift heavy things.
  • Do not bend so that your head is lower than your waist.
  • Avoid driving till your vision improves.
  • Avoid sleeping on the operated side.
  • No sexual intercourse until permitted by the doctor.
  • Avoid alcoholic beverages.
  • Watch television for short periods only.
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