Cataract Surgery

In normal vision, the light will pass through a clear lens on the eye. This lens focuses the light so that the brain and eye can process the information obtained into a picture. When this lens becomes cloudy, known as a cataract, the eye cannot focus light. This leads to blurry vision or other symptoms, like a glare or halos around the bright lights.
The cloudy natural eye lens is replaced with an artificial intraocular lens in cataract surgery.

 

Symptoms

Cataract surgery may be recommended in the following cases:

1. Vision problems due to cataract
2. Interference with daily activities like driving and reading due to cataract
3. Correction of age-related problems in the retina (tissue present at the back of the eye)
4. Diabetes-related retinopathy (damage to the blood vessels in the retina due to poorly-controlled diabetes)
5. Dislocated lens (when the eye lens moves out of its position due to the breakage of the supportive ligaments)
6. Retinal detachment (a condition in which the retina pulls away from the supportive tissue)

Symptoms:

The symptoms associated with cataracts are:

1. Blurred, clouded, or dim vision
2. Sensitivity to glare and light
3. Disturbed vision at night
4. Need for brighter light to read and perform other activities
5. Visible halos around lights
6. Fading of colors
7. Frequent changes in the prescribed eyeglass or contact lens numbers
8. Double vision in one eye

Diagnosis

1. Physical examination: The ophthalmologist will examine the eye of the patient and note down the symptoms and medical history of the patient.
2. Visual acuity test: This procedure helps in measuring how well a patient can read a series of letters on an eye chart.
3. Slit-lamp examination: The structures at the front of the eyes can be viewed under magnification using a slit lamp to check for any abnormalities in the eye.
4. Retinal exam: The doctor will first put some eye drops in the eye to open the eye pupil (the black portion in the center of the eye) wide. An ophthalmoscope (a special device used to view the back of the eye) or a slit lamp is then used to examine the eye lens for any signs of a cataract.
5. Applanation tonometry: The fluid pressure in the eye can be measured using this test.
6. Eye and orbit ultrasound: This test involves the use of high-frequency sound waves to obtain clear images of the eye and the eye orbit. This enables the doctor to choose the correct type of intraocular lens (IOL) for a particular patient.

 

Treatment

The procedure is normally done under local anesthesia by numbing the eye using an injection or with eye drops. The surgery may be performed in the following different ways:

1. Extracapsular cataract surgery: The procedure involves removing the lens of the eye while keeping its posterior capsule (the barrier between the front and back eye portions) in place. This procedure may be done in the following different ways:

2. Small incision cataract surgery: 
The doctor first makes a small incision of 5.5 to 7.5 mm in size on the white portion of the eye. 
The eye lens will be approached through this incision and then manually broken down into several pieces using special instruments.
The broken part of the eye lens will be suctioned out of the eye.
An IOL is placed in the place of the damaged lens.
The incision is then closed using sutures.

3. Phacoemulsification:
This is the most common type of cataract surgery.
The doctor first makes a small incision of 2.2-3.2 mm on the outer eye and introduces a tiny probe into the eye to reach the eye lens. 
The tiny probe will give out ultrasound waves to break down the eye lens into tiny particles.
The doctor will then use another probe to suction out the broken lens. 
After the extraction of the entire natural lens, an artificial lens will be inserted inside to take its place.
The incision usually heals on its own and does not require sutures.

4. FLACS (Femtosecond Laser-Assisted Cataract Surgery):
This technique involves the use of a laser to make a small incision and then remove the clouded lens after breaking it into small pieces.
An IOL then replaces the clouded lens.
This procedure offers a good level of precision and fewer complications than other types of cataract surgery.

5. Intracapsular cataract surgery:

This procedure involves the use of the entire eye lens and is performed as follows:

The doctor first makes a large incision of 8-10mm diameter on the outer eye.
A tiny probe will be introduced into the eye to reach the eye lens. 
The probe extracts the affected lens as a whole from the eye. 
An IOL is then placed in the place of the damaged eye lens.
The incision made is then closed using surgical sutures.  

Risks

 

The various complications associated with cataract surgery are:

1. Eye infection, swelling, or bleeding
2. Eye pain
3. Blurred vision
4. Loss of vision
5. Inflammation in the eyes
6. Drooping eyelid
7. Damage to the other eye parts
8. Retinal detachment (separation of the retina from the back of the eye)
9. Visual disturbances, like halos, shadows, and glare
10. Dislocated intraocular lens
11. Secondary cataract 
12. Glaucoma (damage to the nerve that connects the eye to the brain, leading to high eye pressure)

After Procedure

1. Most patients go home within 30 minutes after cataract surgery.
2. You will not have any sensation in the eye for a few hours after the procedure.
3.  The doctor places an eye patch over the treated eye to protect the eye against dirt, wind, dust, sunlight, and other particles that could lead to irritation to the eye.
4. You may have blurry vision after the removal of the eye shield. 
5. The eye will gradually heal and get adjusted to the artificial lens.
6. It is normal to have some discomfort and itching in the eye for a few days after the surgery. Avoid rubbing or pushing the eye during this time.
7. You need to go to the doctor for a follow-up appointment one to two days after surgery, then one week after surgery, and then after a month to ensure that the artificial lens has adjusted well and the eye has healed completely.
8. Certain eye drops and medications will be prescribed by the doctor to control the pressure of the eye, prevent eye infection, or decrease any eye inflammation. 
9. Complete healing following a cataract surgery may take approximately eight weeks.

Home remedies:

The following tips can help in a smoother recovery following cataract surgery:

1. Use the eye drops recommended by the doctor.
2. Use sunglasses while stepping out of the house.
3. Use eyeglasses, an eye shield, or an eye pad to protect your eyes.
4. Do not press or rub the eye.
5. Avoid any water or soap from getting into the eye.
6. Avoid performing strenuous activities.
7. Avoid using any eye makeup for one week after the procedure.
8. Avoid driving till the doctor permits the same.
9. Avoid swimming for at least two weeks after surgery.
10. Avoid flying till the doctor permits you for the same.

Benefits:

Cataract surgery has the following advantages:

1. Improved vision
2. Improved differentiation between colors
3. Have less glare when looking at bright lights

Cost of Cataract Surgery in India-

The cost of cataract surgery in Mumbai is between INR 25,000 to INR 1,50,000.
The cost of cataract surgery in Delhi is between INR 23,000 to INR 1,30,000.
The cost of cataract surgery in Bangalore is between INR 23,000 to INR 1,30,000.
The cost of cataract surgery in Chennai is between INR 20,000 to INR 1,10,000.