Cataract

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:

1. Cloudy or blurry vision
2. Difficulty driving at night
3. Difficulty reading or watching television.
4. Difficulty in recognizing colors. Colors seem faded.
5. Glare at night.
6. Haloes around lights.
7. Poor night vision.
8. Double vision or multiple images in one eye.
9. Poor vision in bright light
10. Frequent prescription changes in eyeglasses or contact lenses.

Causes of Cataract:

1. Aging: The most common cause, as the proteins in the lens can clump together over time, forming cloudy areas.
2. Genetics: A family history of cataracts can increase your risk.
3. Diabetes: High blood sugar levels can lead to changes in the lens.
4. Sunlight Exposure: Prolonged exposure to UV rays can contribute to cataract development.
5. Smoking: Tobacco use is linked to an increased risk of cataracts.
6. Alcohol Consumption: Excessive drinking may raise the likelihood of developing cataracts.
7. Eye Injuries: Trauma to the eye can lead to cataracts.
8. Certain Medications: Long-term use of corticosteroids and other medications can increase the risk.
9. Health Conditions: Conditions like hypertension and obesity may also be contributing factors.
10. Previous Eye Surgery: Past surgeries can increase the risk of cataract formation.

Maintaining a healthy lifestyle, protecting your eyes from UV light, and managing health conditions can help reduce the risk of cataracts.

Diagnosis &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

1. Age Related or Senile Cataract: Most cataracts are related to aging.
2. 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.
3. Traumatic cataract: Cataracts can develop after an eye injury, sometimes years later.
4. Congenital cataract: Some babies are born with cataracts or develop them in childhood, often in both eyes.
5. Radiation cataract: Cataracts can develop after exposure to some types of radiation.
6. Steroid-Induced Cataract: Cataract develops due to side effects of drug

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:

1. 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.”
2. 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.
3. 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 cataracts 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

1. A highly customized and precise treatment
2. No Injection, no stitch, No Bandage procedure
3. Self-sealing and painless.
4. Shorter overall duration of surgery
5. Less post-operative discomfort
6. Rapid visual recovery and early rehabilitation
7. Perfect early restoration of vision with lifestyle lenses.
8. 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.

Doctor Speak:

Surgery Patient Speak:

FAQ about Cataract Surgery and Phacoemulsification

1. How is phacoemulsification different from traditional cataract surgery?

→Phacoemulsification is a minimally invasive procedure compared to traditional cataract surgery. It usually requires only a small incision and involves less recovery time. Traditional methods might use larger incisions and could involve more extensive tissue manipulation.

2. Is phacoemulsification a common procedure?

• →Yes, phacoemulsification is the most common and widely used technique for cataract surgery today due to its effectiveness and safety.

3. What are the benefits of phacoemulsification?

• →Benefits include a shorter recovery time, reduced risk of complications, and often better visual outcomes. The small incision usually heals quickly, and most people experience significant improvement in vision.

4. What should I expect before the surgery?

• →Before the surgery, you’ll have a thorough eye examination to determine the extent of the cataract and to plan the surgery. You may need to stop wearing contact lenses for a period before the exam, and your eye doctor might suggest certain preoperative tests.

5. How is the surgery performed?

• →The procedure is typically performed on an outpatient basis. During the surgery, a tiny incision is made in the cornea. An ultrasonic device is used to break up the cataract lens, and the fragments are removed. The artificial lens is then inserted into the eye through the same incision.

5. 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
  

6. What should I expect during recovery?

• →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 anesthesia removal of the cataract will be performed using the cutting edge Phaco technology of centurion vision system with implantation of lifestyle intraocular lens.
  
• →Recovery is generally quick, with many people noticing improved vision within a few days. You may experience some temporary discomfort, such as mild soreness or a gritty feeling in the eye. Your doctor will provide specific post-operative care instructions. 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.

7. Are there any risks or complications?

• →While phacoemulsification is very safe, potential risks include infection, bleeding, inflammation, or vision changes. Serious complications are rare, but it’s important to follow your doctor’s post-operative instructions to minimize risks.

8. When can I return to normal activities?

• →Most people can resume light activities, like reading and watching TV, within a few days. However, you should avoid strenuous activities and heavy lifting for a few weeks as recommended by your surgeon.

9. Will I need glasses after surgery?

• →Many people experience improved vision without glasses, but some might still need glasses for certain tasks, such as reading. Your eye doctor will discuss this with you based on your individual needs and the outcome of the surgery.

10. How long will the artificial lens last?

• →The artificial lens used in cataract surgery is designed to last a lifetime and does not usually need to be replaced.

11. Can cataracts return after surgery?

• →The cataract itself does not return, but a condition called Posterior Capsule Opacification (PCO) can occur, where the membrane behind the lens becomes cloudy. This can be treated with a quick, painless laser procedure.

12. How do I know if cataract surgery is right for me?

• →Your eye doctor will assess your vision and overall eye health to determine if cataract surgery is appropriate. If cataracts are affecting your daily life and vision, surgery is often recommended.