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Phaco Emulsification Cataract Surgery |
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Phacoemulsification
Cataract Surgery
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Cataract surgery
at Sushil Eye Hospital
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1. What are Cataract ?
A cataract is the clouding of the normally clear, natural crystalline lens of the eye. The lens is composed of water and protein. The protein is arranged in a highly organized pattern that allows light to pass through it with minimal distortion. As a result, the lens appears virtually clear. The lens can become cloudy (see Causes of Cataracts), blocking or scattering some light and preventing it from reaching the retina in sharp focus. This causes blurred vision and glare.
Most cataracts progress slowly over a period of years, but their rate of progression is unpredictable. They can affect one eye or both eyes. As cataracts become more dense, they produce visual symptoms; these typically include blur, glare, halos around lights, and double vision. Colors can become dull, a brown-yellow tint is common, and driving can become dangerous. Untreated, cataracts can cause blindness. In the U.S., however, cataracts are usually treated when they begin to interfere with activities of daily living such as reading and driving.
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2. What causes Cataract ?
- Mostly Age is older than 60 years have cataracts.
- Medical conditions. Diabetes and other systemic diseases, Glaucoma, and metabolic abnormalities can cause cataracts.
- Physical injuries. Commonly called traumatic cataracts. A blow to the eye, great heat or cold, chemical injury, exposure to radiation (usually associated with radiation therapy for cancer patients), and other injuries can lead to cataract formation.
- Ultraviolet radiation (UVA or UVB). Long-term exposure to sunlight is believed to speed the development of cataracts.
- Oral steroids and other medications. Oral steroids (such as Prednisone), the gout medication Allopurinol, the breast cancer drug Tamoxifen, the heart medication Amiodorone, and the long-term use of Aspirin have also been associated with cataracts.
- Smoking. Studies indicate that smokers are twice as likely to develop cataracts than nonsmokers and that quitting can reduce the risk for developing cataracts.
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3. What are the Benefits of Cataract Surgery ?
In the mid- and late 1990s, numerous medical studies were conducted to help us understand how cataract surgery affects the quality of life of older people. It was found that patients who had cataract surgery enjoyed an improvement in their quality of life, reflected in their driving skills, community activities, home activities, and mental health.
Driving and Cataract Surgery
More recent studies continue to document cataract surgery's benefits. A study found that older people who have cataract surgery reduce their chances of having a car accident by more than 50 percent. In India older or handicapped people are really not looked after well adding to their sufferings.
Despite the proven benefits, many patients are reluctant to have cataract surgery. They may delay it because of a lack of family support, the need to address other chronic conditions, or the mistaken perception that cataract surgery requires a significant amount of time for recovery.
Today, most cataract operations are performed in an outpatient setting and do not require admission to a hospital. Twenty years ago, thick glasses were prescribed so that people who had cataract surgery could see. In the past two decades, however, small artificial lenses that can be implanted in the eye have been developed. These intraocular lenses (IOLs) can provide good distance vision with thin glasses or, sometimes, without
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4. What are the symptoms of a cataract ?
Typical symptoms include :
- Cloudy, fuzzy, foggy, or filmy vision.
- Changes in the perception of colors.
- Problems driving at night because headlights seem too bright.
- Problems with glare from lamps or the sun.
- Frequent changes in your eyeglass prescription.
- Double vision.
These symptoms can also be signs of other eye problems. If you have any of them, consult an ophthalmologist for an eye examination.
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5. How do I decide to have surgery ?
Most people have plenty of time to decide about cataract surgery. Your doctor cannot make the decision for you, but talking with your doctor can help you decide.
Tell your doctor how your cataract affects your vision and your life. Read the statements below, see which ones apply to you, and tell your doctor if:
- I need to drive, but there is too much glare from the sun or headlights.
- I do not see well enough to do my best at work.
- I do not see well enough to do the things I need to do at home.
- I do not see well enough to do things I like to do (for example, read, watch TV, sew, hike, play cards, and go out with friends).
- I am afraid I will bump into something or fall.
- Because of my cataract, I am not as independent as I would like to be.
- I cannot see well enough with my glasses.
- My eyesight bothers me a lot.
You may also have other specific problems you want to discuss with your eye doctor.
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6. What are different types of Intraocular Lenses (IOL)?
There are various types of lenses broadly Two main varieties Rigid and Foldable .Rigid Lenses need bigger incision of 6 mm to insert inside the eye.These lenses were first generation Lenses.These give good Monofocal Vision,while as Foldable Lenses can be inserted through a small port of 1-2.5 mm only giving fast recovery and does not cause change in curvature of the cornea.
Newer modifications like square Edge and Asphric Lenses give good contrast of vision.and reduces chance of Capsuler Opacification.
Newer lenses like Multifocal Lenses give good vision for distance and near reducing dependence on glasses.
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Phacoemulsification |
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The most common and advanced cataract surgery technique is phacoemulsification or "phaco." The surgeon first makes a small incision at the edge of the cornea and then creates an opening in the membrane that surrounds the cataractous lens. This thin membrane is called the capsule. Next, a small ultrasonic probe is inserted through the opening in the cornea and capsule. The probe's vibrating tip breaks up or "emulsifies" the cloudy lens into tiny fragments that are suctioned out of the capsule by an attachment on the probe tip. After the lens is completely removed, the probe is withdrawn leaving only the clear (now empty) bag-like capsule, which will act as support for the intraocular lens (IOL).
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The phaco probe emulsifies the cataract and removes the resulting fragments.
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Phacoemulsification allows cataract surgery to be performed through a very small incision in the cornea. Stitches are seldom needed to close this tiny entry, which means that there is less discomfort and quicker recovery of vision than with other surgical techniques. Small incisions do not change the curvature of the cornea like larger ones that were required with older surgical techniques. This allows for more rapid rehabilitation of vision and possibly less dependence on glasses for good distance vision.
After removal of the cataract-damaged lens, an artificial Intraocular Lens (IOL) is implanted. Made from soft acrylic or solid medical-grade silicone, IOLs are folded so they can be implanted with a small injector, which uses the same incision through which the phaco probe was inserted at the beginning of the procedure. As the IOL is implanted, it unfolds and anchors itself behind the eye's pupil over the remaining clear capsule. The IOLs to be implanted are selected based on power calculations made before surgery.
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The replacement for the cataract-damaged natural lens, the Intraocular lens (IOL), is positioned in the capsular bag of the eye. Throughout the procedure, most patients are awake, relaxed, and feel no pain.
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