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

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.

Can cataract develop again after cataract operation?

Cataract can never develop again. However in some patients the lens capsule thickens and acts like a curtain behind the IOL. Technical name of this defect is posterior capsule thickeneing. Due to this curtain vision again deteriorates.

Most of the people do not develop but following factors can increase the chances of development of the membrane:

• Old fashioned IOLs have greater chances of this problem. Most of the latest IOLs have decreased the chances of development of after-cataract..
• Very very important thing is that the lens matter should be cleaned in vary good manner. Incomplete cleaning of cortical matter increases the chances. the incompleteness may be due to poor quality machanies or inadequate surgical experience.
• If after operation there remains chronic inflammation, it incraeses the chnaces.

It is a miracle of modern technology. Many times, when we the doctors sit down together; we are amazed at the fact in the past we used to use many kinds of injections to execute the operation. And we had to encounter what kind of complications which they caused. In fact, as nowadays, there is minimal trauma, so now it is possible to finish the job with the help of just drops without using any kind of anesthetic injections. Some techniques are being introduced in which even use of drops is not required.

This laser machine is used to treat

• Narrow angle glaucoma.
• After-cataract which develops in eyes which have been operated for cataract..

In the following picture glaucoma is being treated.

یہ لیزر مشین جسے Yag laser کہتے ہیں درج ذیل مقاصد کیلئے استعمال کی جاتی ہےَ:

• نیرواینگل گلوکوما  کے علاج کیلئے۔ اس کے ذریعے آئرس میں سوراخ کئے جاتے ہیں جو نکاسی کے لئے متبادل راستے کا کام کرتے ہیں۔
• سفید موتیا کے اپریشن کے بن جانے والی جھلی کو ختم کرنے کیلئے۔

?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