What is cataract surgery and when do you need it?
The most intriguing question that strikes one’s mind is what happens during a cataract surgery? So in 99% of cases we do the surgery by phacoemulsification where in we introduce a phaco laser probe through 2.2mm/2.4mm hole ( quite like a pin hole) under the magnification of an operating microscope and quite meticulously break the cataract into smaller fragments which are removed through suction. The space created is thoroughly cleaned and an intraocular lens is implanted in place of the natural lens.The next question is when do we undergo cataract surgery. Technically earlier the better. Softer the cataract lesser the energy used to break the cataract and hence lesser the collateral damage to surrounding tissues, so better visual outcome and faster recovery. However the consensual guidelines suggest cataract surgery should be done when best corrected visual acuity drops to 6/12 for distance vision. But still there certain types of cataract like posterior subcapsular, cortical, posterior polar which affect vision and contrast sensitivity differently. Hence its best to be left at the discretion your treating physician.
What are the different intraocular lenses available?
There are 5 main categories of lenses available from different brands across the globe. The Monofocal lenses being the oldest category which give good Distance vision although one may need to wear glasses for reading after surgery.The Enhanced Monofocal lenses is a relatively newer category which gives good Distance and Intermediate(80cm) vision enabling one to see distant objects clearly as well as phone and text easily.The Multifocal lenses do give good distance and near vision but can cause glare and halos during night driving due to presence of rings in the lens design.so these lenses are useful for those who do not need to drive at night.The Trifocal lenses are a rage nowadays due to the continuous range of vision across all distances it provides, be it distance vision, near(33-40cm) or intermediate (60-80cm) vision. However some individuals might experience reduced contrast sensitivity and night vision disturbances. These are not quite recommended in diabetic individuals.However the void of trifocal lens eligibility is filled in by yet another advanced lens design called the ‘EDOF’ lenses(Extended Depth Of Focus) lenses. Unlike the rings in trifocal and multifocal lenses these give and elongated focus which helps the patient see across all range of distances quite seamlessly.
Which intraocular lens will be best suitable for me?
Depending upon one’s eye condition, cataract grade and type, systemic condition, occupational/social requirement, your ophthalmologist would be best to guide you which lenses would suit your requirement. He/she will then calculate the power of the IOL(intraocular lens) based on different eye measurements takes via Biometry(A-Scan).
What are the precautions to be taken before surgery?
If you are suffering from any systemic illness like Diabetes, Hypertension, Cardiac disease, Benign Prostrate Hypertrophy, Asthma, COPD kindly notify your doctor so as to make necessary modifications and arrangements. Antiplatelet/ Blood thinners should be stopped 3 days prior to surgery. Other Medications must be taken as advised. Do not omit anti hypertensives or oral hypoglycaemics. Antibiotic eyedrops should be started 3 days prior to surgery. Eyelids should be scrubbed and cleaned on the day of surgery.
What are the post operative precautions to be taken after cataract surgery?
If the surgery is done under topical anaesthesia (just drops used as anaesthetics), you can remove the patch after 2 hrs and start putting the eyedrops as advised. Avoid dust, smoke, water going into your eyes for a week. Wear protective glasses. The wound seals with 48 hours. Avoid face wash and head bath for a week. There is no restriction to food and watching television or mobile or computer screen. There can be slight watering, redness for 2-3 days which is normal, vision stabilises by one week. Eyedrops advised must be instilled with all aseptic precautions timely. Eyes can be cleaned with disposable eye wipes only.
Should I undergo Cataract surgery during summer season?
It’s the most prevailing myth of all times, but in today’s scenario, there are no big cuts or sutures applied in cataract surgery unlike in olden times. It’s a simple pinhole surgery in which the wound seals within 48 hrs thus minimising all risks of infection. Hence there is no valid reason to delay cataract surgery.