Cataract and Phaco Surgery

Cataract and Phaco Surgery

About Cataract

A cataract is a clouding of the natural lens in the eye that affects vision.  The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light sensitive tissue at the back of the eye. In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image will be blurred.

Symptoms of Cataract

People with cataract, even when wearing glasses, typically experience:

  • Cloudy or blurry vision.
  • Difficulty driving at night
  • Difficulty reading or watching television.
  • Difficulty in recognizing colours. Colors seem faded.
  • Glare at night.
  • Haloes around lights.
  • Poor night vision.
  • Double vision or multiple images in one eye.
  • Poor vision in bright light
  • Frequent prescription changes in eyeglasses or contact lenses.

Types of Cataract

  • Age Related or Senile Cataract: Most cataracts are related to aging.
  • Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
  • Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
  • Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes.
  • Radiation cataract. Cataracts can develop after exposure to some types of radiation.
  • Steroid-Induced Cataract: Cataract develops due to side effects of drug.

Treatment for Cataract

There are no medicines with proven efficacy to prevent or treat cataract. The only effective treatment for cataract involves surgery is to remove the cataract and replace it with an intraocular lens implant. It is the most common surgical procedure around the world and is considered to be extremely successful and safe. Diabetes, hypertension and other general health problems are not a contraindication for cataract surgery and the cataract need not ‘mature’ for surgery. A cataract needs to be removed when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age related macular degeneration or diabetic retinopathy. If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times. Many people who need cataract surgery also have other eye conditions, such as age related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

Types of cataract surgery

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

  • Phacoemulsification, or Phaco. A small incision is made on the side of the cornea, the clear, dome shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”
  • Extra Capsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction. After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.
  • Phacoemulsification technique: Cataract extraction by phacoemulsification through a micro-incision and implanting a foldable lntra-ocular lens is a definite technological advancement from conventional surgery. The cloudy cataractous lens is aspirated out with a suction device.
  • The IOL is injected into the eye through the small incision and it unfolds and is positioned correctly in the eye. It can be Mono-focal, Multifocal or Toric lens depending on the requirement of the patient, which will be decided by the surgeon in agreement with the patient. The surgical procedure is done under local/topical anesthesia and the incision is so small that it heals by itself.

Advantages

  • A highly customized and precise treatment
  • No Injection, no stitch, No Bandage procedure
  • Self-sealing and painless.
  • Shorter overall duration of surgery
  • Less post-operative discomfort
  • Rapid visual recovery and early rehabilitation
  • Perfect early restoration of vision with lifestyle lenses.
  • Wound stability is far better since the entire surgery is done through a very small opening

Types of Lens Implants 

When undergoing cataract surgery or refractive lens exchange, you have options when it comes to intraocular lenses (IOL). Below are the different types of IOLs that can be implanted during your surgery. Patients can choose the standard IOL or select from several “Lifestyle Lens” options.

Standard, Single Focus or Monofocal Lens

With basic cataract surgery, the cataract is removed and replaced with a standard, single focus IOL. This lens can correct for the impairment caused by the cataract but it will not ensure the patient’s independence on prescription glasses for other vision problems.

Toric Lens - Lifestyle Lens

With a toric IOL, patients are able to achieve the same results of basic cataract surgery, but will have the added benefit of vision correction. This specialized IOL has the ability to correct astigmatism (a condition in which the shape of the cornea is irregular, causing vision to degrade without the help of corrective eyewear). A toric lens can help to adjust the focus of light appropriately for individuals who have astigmatism.

Multifocal Lens - Lifestyle Lens

This type of lifestyle lens corrects the patient’s ability to see at a distance, and can provide an improved ability to adjust focus at near or intermediate distances. A multifocal IOL can virtually eliminate a dependence on glasses for most patients. Some patients may still use glasses to see very fine details up close. Due to the unique capabilities of this IOL, the patient may need to go through an adjustment period, similar to adjusting to a new pair of bifocals or progressive lenses.

Multifocal Toric Lens - Lifestyle Lens

A multifocal toric lens provides all the same benefits of a multifocal lens, but also corrects for astigmatism. Light entering the eye is focused to adjust for an oblong-shaped cornea, and vision at varying distances can also be improved.

Refractive Lens Exchange (RLE)

Refractive Lens Exchange (RLE) may be an option for those who require vision correction. RLE is an alternative to LASIK and other forms of refractive surgery. RLE is a procedure similar to cataract surgery, but can be performed on patients without cataracts. RLE can also be used to prevent cataracts from forming in the future. The options for this surgery are the same as what is available in cataract surgery. The patient can choose a standard, single focus lens or one of the lifestyle lenses listed above. If the patient selects a standard IOL, they will still require reading glasses for near vision. With a lifestyle lens, patients can eliminate some or all dependence on prescription glasses.

Facilities available at Dhaka Eye Care Hospital for diagnosis and treatment of cataract:
  • Advanced diagnostic equipment to detect cataract and calculate the IOL power
  • Zeiss-operating microscope Lumera 700  from carl Zeiss, Germany for micro-surgical procedures
  • High-end Centurion vision system Phacoemulsification machine from Alcon USA and Whitestar Signature Phacoemulsification machine also from USA.
  • World-class operation theatre
  • Comfortable day care facility for post-operative care
What Should I Expect On The Day Of Surgery?
You will be called to the hospital 2 hours prior to the surgery for dilatation of pupil and preparation of the eye to be operated. Under topical or surface anaesthesia removal of the cataract will be performed using the cutting edge Phaco technology of centurion vision system with implantation of lifestyle intraocular lens.
 
How Long Does The Procedure Take?
You can expect the total duration of your stay in the hospital for about 2 to 3 hours. You will be in the operation room for about 15 minutes.
 
What Should I Expect For Recovery?
Normally you will be able to see after 10-15 minutes after the surgery, but vision may be blurry. Most patients see well on next day, but in some cases for example, hard and mature cataracts; it may take 2 to 3 days for full visual recovery.
 
Contact DHAKA EYE CARE HOSPITAL
If you need more information about cataract surgery or refractive lens exchange, or if you would like to schedule a consultation with one of our experienced eye surgeons, please contact us today.