How cataract operation is performed? Eye is taken out of the body?

With regard to the timing of the operation, it is now a general rule that the operation will be decided on the basis of the patient’s disability. Therefore, a young patient who has to drive a car and work on a computer will be advised to have an operation immediately, even in the presence of very good eyesight. In contrast, an old man who is old and weak has not been able to read and write, and has no special preoccupation with the necessities of life except for a small house. Don’t insist too much. And advise them that if you want to make a living now, do it

And if you want to have an operation, then of course have an operation today. Most of these elders have their own desire that I can see now so they do not operate on me.

But the ideal method should be to have the operation done as soon as possible. Now the operation is done so well that the operation is completed in just a few minutes. You don’t even have to take a lot of precautions later. And now the results of the operation are very good in the majority of patients. Then there is the important fact that lying down often leads to various complications, the doctor has difficulty in performing the operation and there is a great risk that the results will not be very good. Emergency surgery is not required, but prolonged procrastination is often detrimental.

What is the difference between phaco surgery and operation with stitches?

In the older technique to remove cataract, a large incision is made,  then a rigid artificial lens is inserted through the large incision. After the procedure, the incision is closed with fine stitches. This method is even now used but only when there is some complication during surgery or when situation does not allow phaco surgery. In mant places where funds is issue and surgeon is bound to adopt cheaper technique, at those places this method is used even nowadays.

The newer and much more beneficial method is phacooperation. In this a small incision is given, the cataract is removed by braking it into small pieces with the help of ultrasound waves, and those pieces are removed through the small incision. Then a soft lens is inserted into the eye through through the small incision. So a large thing is removed through a small hole! Because theincision is so small, it sel-seals and there is no need for stitches are not needed to close it.Following picture help in understanding

The realities of the weather, although it is a bitter fact, are reality. In most people cataract surgery is not an emergency operation. Then there is the fact that the standard treatment for cataract is an expensive treatment that requires a considerable amount of money, and obviously the income of many of our people is directly or indirectly related to income from crops. The crops have deep relationship with weather. In the same way, the hot weather and the humid weather creates fear in everyone’s heart that the wound may not become infected.

The poor people obviously can’t even think of air conditioning in our country but now the issue of elctric load-shedding has made life very much difficult even for the rich people.

Therefore, there is still a tendency among people not to have surgery in hot and humid weather. Then there are the holidays for children and for employees. This is the reason why in spite of doctors irrelevance to weather, patients keeps on sticking to the concept of good weather for operation!

However, it is also a fact that since the technology of the cataract operation was not so good in the past, so there was a great risk that something bad might happen. Then even the best operation would not have very good results and good antibiotics were also not avaialbe so the sword of infection was always horrifying all, so in hot and humid weather, operations were mostly deferred. There is no need for such a precaution anymore. Observing the seasons is no longer important from a medical point of view.

There are two types of lenses which are implated after removal of cataract:

1. Foldable IOL
2. Non-foldable IOL

NonFoldable lens

These lenses are made up of hard material. A large incision is made to insert them. Most are now becoming obsolete. As the incision is very large so the wound is closed by stitches.

Foldable IOL lens

These are lenses made of soft material. They can be easily folded so a small incision is made in the eye. This lens is inserted into the eye through this small passage by an injector. Once inside, they open up and enlarge again. Following are different types of foldable lenses:

It is not that lenses cause a lot of problems. Many people get into trouble after removing the lenses. Is that true?

Most of the problems that arise after the operation are usually associated with the lens. However, this is actually a huge misunderstanding. Probably only one in a thousand problem may be related to the lens.

The problems that patients usually face after the operation are:

• persistent pain after the operation.
• persistent watering from eyes.
• persistance of redness inside the eye.
• improper restoration of vision.

In fact, perhaps none of these have relationship with the presence of lenses but they are directly associated with the quality of the operation. In fact, the operation may not have been good or there may have been a complication that is causing these problems. Of course, different types of lenses are related to the quality of vision, but not to the problems mentioned above. People generally think that the operation should be done from anywhere lens should be good be of good quality. A little compromise on the quality of the lens is not as harmful as compromising on the quality of the operation. Before performing the operation it is important that:

• The first thing that needs to be considered  is about
  • What are the skills of surgeon performing the operation?
  • What are the chances of complications during his operation?
• Then the quality of operating theater which should be considered.
• What is the level of technology in this operating theater because even a good surgeon will not be able to perform a good operation with any substandard quality machines and even a mid-skilled surgeon is more likely to perform a good operation on good machines.
• Last but not lease is the standard of infection control. The best machines are, but if there is an infection in the eye, the results of the operation are never good.
• Another thing is about the Is the facility to deal with a complication if it occurs.

?What is a cataract

What is cataract? Each eye has a lens that is perfectly transparent. It focuses light rays and creates an image on the retina which is perceived by brain. For various reasons the lens transforms into an opaque ball can’t transmit light rays to the retina. The vision is affected by the same ratio by which the transparency is reduced. The name of this condition is cataract.

Is it possible to treat cataract without operation? Maybe some oral medicine or some eye drops or some exercises?

There are certain things that can be done to prevent cataract formation. In the same way, cataract formation has started, its speed may be slowed down. Some examples are discussed I following paragraph.

1. If general health is maintained, the chances of cataract are development is significantly reduced.
2. Balanced food intake can play role in prevention of cataract formation.
3. Caution in the use of drugs that are risky in this respect eg steroids.
4. Prevention or strict control diseases that are more likely to cause cataracts, such as diabetes, hypertension, thyroid dysfunction.
5. Obesity and cholesterol abuse.
6. Exercise and protection against hazardous climate.

Certainly, some products have the potential to clear the lens of obesity. Really, the expectations from these products are quite ambitious. Most of them are beneficial at early stages of cataract, If already have advanced, then of no use. These products mostly contain vitamin A, vitamin C, vitamin E, carotenoids, and some iodine compounds. Expectations of many are linked with many homeopathic drugs and herbal compounds. Much research is going on in this regard. Hopefully, treatments will be discovered which will reduce the number of operations.

My daughter is 6 months old. The cataracts has been diagnosed in her both his eyes. Why cataract developed in so young child? Can it be treated without surgery?

Most children develop as a result of some congenital deformity. As at early stage the child was not examined properly so could not be diagnosed.

The second reason is mostly that there was an injury at some point of pregnancy. The cataract can be developed shortly after the injury.

A third reason may be that the baby has been very ill at some point. The cataract may have been developed due to side-effect of the drugs used for prolonged time.

In some children, there is another congenital disease such as Down’s syndrome, which causes a damaged natural lens.

Is it reality that the operation is performed without injection and stitching?

It is a miracle of modern technology. Many times, when we ophthalmologists sit down together, we are amazed at the number of injections we used to give for operation and what kind of complications we used to encounter! In fact, as the incision is very small and it is self-sealing, so it has really possible to perform operations without injections and without stitches. Some people are introducing methods that will not require even anesthetic drops.

How is the operation performed? Do you take the eye out of the body during an operation?

This is a question that most patients ask. Due to this misconception people are very afraid of the operation.

What is the difference between the operations using stitches and suturless operations? 

In older technique, first a long incision was made, from which the lens was extracted, and then a rigid type of artificial IOL was inserted. After this the incision was sealed tightly with stitches. Now a small pathway is made to remove the damaged lens by braking it into small pieces by means of radiations, and through the same small incision a soft foldable lens is inseted with the help of a special type of injector. Since the incision is ver small and it is constructed in such a way it self-seals so no stitches are needed.

?How are the machines are used during the operation

Following are some pictures taken durin operation. by looking at these picture you can imagine the real environment of operation.

Position of the position while being operated

Latest model of operation microscope by Zeiss with Lumera feature and Alcone company’s Latest Phaco machine

  

Latest model of operation microscope by Zeiss with Lumera feature and Oertli company’s Latest Phaco machine