Dr Kushal Kr Choudhuri, Consultant Opthalmologist, AMRI Medical Centre elaborates about cataract, its effects and surgery methods
Cataract is the largest single cause of blindness in the world. Some people lose their livelihood, some suffer from accidents like falling down and injuring themselves at home or outside, suffering from burns in the kitchen. Others face difficulties in daily life like inability to read fine print or cross the street safely at night etc leading to a poor quality of life. The economic and social effects are enormous, to say the least.
Unfortunately, the only treatment for reasonably advanced cataract is surgery. Fortunately, the surgery is quick, effective and fairly trouble free for the vast majority of people. With the technological improvements, it has become even more accessible, safer, quicker and effective so much so that unless the person has got other ocular abnormalities or something unfortunately goes wrong during the surgery or after that (both possibilities being quite rare in good hands and if the patient follows the post operative instructions diligently), one can expect excellent visual quality after the procedure.
Technology has played a major role in this regard. Nowadays, the surgeons are able to examine and evaluate the status of the eye in much more detail than ever before. The pre- operative slit lamp microscopy and examination of the back portion of the eye using sophisticated and powerful lenses can reveal a lot of crucial information, which is sometimes complimented by additional advanced tests like specular microscopy, corneal topography, pachymetry, perimetry and OCT which can tell us about the health of each individual layer of various small parts of the eye. Biometry, done to find out the power of the intraocular lens to be implanted, is getting progressively more developed, with much better precision than ever before.
Cataract surgery has become a day-care procedure with the entire duration of stay in the clinic being a matter of just a few hours with practically no disruption of the daily routine. Most of cataract surgeries are nowadays done by a stitch less method. Phacoemulsification (phaco) is the procedure of choice unless there are technical or financial constraints.
Phaco surgeries are preferably performed just with anaesthetic drops and preoperative local anaesthetic injections are reserved for technically difficult cases or apprehensive patients who are unable to cooperate adequately during the surgery.
The surgical microscopes are state-of-the-art machines allowing the surgeons to visualise every small detail inside the eye, leading to a more precise surgery and better, happier outcome. Attached video cameras allow the patients’ relatives see the surgery in real time.
The phaco machines enable the surgeons to gently remove the cataracts from within the patient’s eye in a quicker manner, leading to less post operative discomfort than ever before.
Soft, foldable intraocular lenses are implanted in the eye for clear vision after surgery. These lenses are also getting increasingly sophisticated. Premium lenses help the patient achieve better vision with lesser dependence on glasses. The premium lenses are, because of their cost, unfortunately still beyond the reach of the common man.
The post operative restrictions are minimal with rapid recovery and resumption of daily life routine. Most of the time, the patient does not need any strong painkillers or oral antibiotics. Just a few eyedrops are usually enough to take care of the recovery process. These have to be used for about six weeks on an average.