Modern cataract surgery is now a walk in-walk out, stitch less, painless procedure performed through 2-3mmincision giving quick visual recovery. For good visual outcome there are many surgical choices to be made in cataract surgery which patients should be aware to be able to make right decisions.
1. Choose your surgeon wisely - Microsurgery on such a sensitive and vital organ demands high surgical expertise. Apart from surgical skills. his empathising attitude and spending time with patients are equally important. A good doctor treats the patient and not just disease.
2. Multifocal vs monofocal lens. Monofocal lens - Patient sees clear for distance but needs glasses for reading. Multifocal lens - Patient can also read without glasses.
3. Diffractive multifocal Vs EDOF multifocal lens - Diffractive Multifocal lenses have diffractive rings on their surface which splits the light into two or three foci on retina. They offer excellent distance, near and in case of trifocal lenses intermediate visual acuity but have side effects of halos, glare and lack of contrast in dim light conditions. They are not suitable for night driving. Whereas Extended depth of focus (EDOF) lenses offer continuous range of vision by optical modification to increase the depth of focus. Incidence of glare, halos is rare and offer good contrast in dim light. However, there is slight trade off in distance visual acuity which is slightly less than diffractive lenses.
4. Aspheric vs Non-Aspheric lens - Intraocular lens with an Aspherical optic has better contrast sensitivity and sharper vision in dim light conditions but are a bit costlier
5. Hydrophobic vs Hydrophilic lens - Hydrophobic lens surface has better biocompatibility and less incidence of post-surgery opacification of lens capsule.
6. Toric vs spherical lens- Toric lens has additional cylindrical power apart from spherical power which is sometimes required for complete spectacle power removal.
7. Needle vs topical (with eye drops)anaesthesia –Choice depends on surgeon’s comfort level, skill and patient's cooperation during surgery. Topical anaesthesia is less traumatic to patient and avoids complications like bleeding and needle eye injury.
8. Femto Laser Assisted Cataract Surgery (FLACS)vs Phacoemulsification – FLACS uses laser instead of blade for incision andlens cutting. Phacoemulsification uses an ultrasound vibrating probe toemulsify and suck the lens out. Incisions in both techniques are stitch lessand of same size. FLACS makes surgery easier for surgeon but has an additional cost to it. In skilled hands both give equal results.
9. Patch vs No Patch – Eye patching for at least an hour after surgery is advisable to give the incisions time to get sealed without stitch.
10. Choice of second eye surgery soon after first one – Second eye surgery may be performed after full recovery of first eye which is usually 1 week. It is prudent to go for other eye cataract surgery within few days of first one as it offers lot of benefits to patients like less visits, early recovery and convenience of putting post operative eye drops in both eyes.
Dr Tarun Arora
Senior Eye Surgeon
ICURE eye care centre
C4F/28, Janakpuri, New Delhi
WA 8851106244
Email- icureclinics@gmail.com