With the advent of the topical anesthesia phaco emulsification procedure, you can now get rid of a cataract without any stitches, injections, eye-pads or bandages. Says Dr Sharad Lakhotia, ``Patients can drive back soon after the cataract operation and go to work or play.''

Lakhotia explains that every normal human eye has a crystalline lens, which focusses images on the retina. When this lens becomes opaque, it is called a cataract. Cataracts normally develop in individuals past 50 years of age. Such cataracts are called senile cataracts. However, cataracts may also be present at birth, when it is termed as a congenital cataract. Cataracts can also develop earlier in diabetics and those who have used cortico steroid medicines for long periods. Somecataracts may follow eye injuries-these are called traumatic cataracts. There is no medicine in the world that can stop or prevent cataracts conclusively.

In certain cases like diabetes, control of the ailment can prevent progression of the cataract. However, all the cases of cataract require surgical treatment. According to Lakhotia, ``Earlier, we used to ask our patients to wait for surgery till the cataract ripened.''

Now with the advent of modern surgery, that is no longer necessary. ``Rather, it is advantageous to operate on a cataract while it is still immature. Nowadays, the dictum is that as soon as the patient feels any difficulty in carrying out day-to-day activities, it is time for surgery,'' explains Lakhotia.

According to him, the latest treatment in cataract surgery is a procedure in which 2.5-3 mm incisions are made in the cornea. Then, using a small needle or forceps, a round circular opening is made in the anterior capsule of the lens, which is called the capsular hexis. Then the phacois introduced through the small incision in the cornea and the cataractous lens is emulsified and aspirated out of the eye.

``Then through the same hole, a foldable intraocular lens is implanted in the eye. As the incision in the cornea is made valvular with the help of a special knife, it becomes self-sealing, requiring no sutures. This latest technique can be done under topical anesthesia, which means no injections, only eye drops applied to the eyes,'' says Lakhotia. This technology is available in all the metros of country.

There are three different packages for the operation, each designed to suit a different pocket: Rs 9,000 (which uses locally made lenses), Rs 12,000 (which uses Heal-on imported lenses and a diamond knife) and Rs 15,000 (which uses Heal-on foldable imported lenses and a diamond knife).

Today, almost 95 per cent of cataract patients opt for the Rs 15,000 package, since it is not very expensive, and in a cataract camp, a patient has to pay just Rs 3,000 as operation charges; therest is free of charge, says Lakhotia. He adds: ``The camps are organised, not because we are targeting the mass population, but to cater to as many patients as possible. And as patients are quality conscious, we feel that even the poorest needs to get the best.'' Lakhotia has to his credit almost 20,000 cataract operations since 1985.

``The patient should be cooperative and not move his eye. He should follow the surgeon's instructions to the letter. If he does all that, no stitches, no eye-pads, no bandages are required,'' Lakhotia points out.

According to Lakhotia, ``One of the major drawbacks of this surgery is that it requires very sophisticated instruments, meticulous precision and a long learning curve. But once mastered, this is the best technique available internationally.'' The machines cost between Rs 5 lakh and Rs 25 lakh, and the entire procedure takes just about 20 painless minutes.