Phacoemulsification Cataract

Cataract is a condition, in which the natural crystalline lens of the eye becomes opaque resulting in an impairment of your vision or even a complete loss of vision.
Cataracts are extremely common and most cataracts are the result of the normal ageing process.
Surgical removal of the cataract is usually safe and effective, resulting in an improvement of vision by letting light pass again to the retina.

What are the causes of cataract ?

Age related metabolic changes of the lens fibre (i.e. senile cataract), traumatic cataract (i.e. cataract due to injury) and congenital cataract (born with) are the common causes of cataract. They may also be secondary to an underlying medical condition like diabetes, excessive exposure to sunlight or abuse of alcohol and smoking.

What are the symptoms and signs of cataract ?

A cataract forms slowly and causes few symptoms and does not alter the external appearance of the eye in any way.
The disease is symptomless in the early stages. As it advances, symptoms like decrease in clarity of vision that is not fully corrected with glasses, is seen.
There is a loss in contrast sensitivity and so shadows and colour vision is less vivid.
A disturbing glare may be noticed as light is scattered by the cataract.
Haloes may be observed around lights.
Night vision may be reduced.
In some cases double vision may be noted.

The lens of the eye is easily examined by your ophthalmologist and the changes in the lens characteristic of cataract can be seen using a slit lamp.

What is the treatment ?

The most common methods of cataract surgery are phacoemulsification and extracapsular extraction. Both procedures preserve the posterior capsule.

  • Phacoemulsification uses sound waves to break up the lens into tiny pieces that are suctioned out.
  • Extracapsular extraction requires a larger incision to remove the cloudy lens. A lens loop is used to remove the entire lens at once.

Surgical removal of the cataract is a simple short-stay procedure lasting between 20 – 30 min and is conducted under topical local anesthesia. Prior to the surgery, eye drops are used to dilate the pupil.

Phacoemulsification is a procedure, in which the natural lens is completely removed while maintaining the lens capsule in which the artificial intraocular lens is implanted. Before the phacoemulsification is performed, one or more incisions are made in the eye to allow the introduction of surgical instruments. The surgeon then removes the anterior face of the capsule that contains the lens inside the eye. The phaco probe is a hand piece with a titanium or steel needle. The tip of the needle vibrates at ultrasonic frequencies to sculpt and emulsify (soften) the cataract while a pump aspirates particles through the tip. The cataract is usually broken into two or four pieces and each piece is emulsified and aspirated out with suction.

What is an IOL implant ?

IOL stands for Intraocular lens. It is a lens implanted into the eye to treat cataracts.
During Phaco surgery, the IOL of appropriate power is fitted inside the eye. The foldable IOLs can be inserted through a very small incision. These are made of high quality material. They unfold in the eye and are permanent and lifelong.

How do you prepare for surgery ?

You will be admitted to the Center on the day of surgery.
An anesthesiologist will review your medical history and discuss the anesthesia with you.
You should not eat or drink anything from midnight the night before surgery (at least 8-10 hours before surgery) and have only a light dinner.

What can you expect post-surgery?

After the surgery you will be taken to the recovery area where a nurse will monitor you clinically. Gradually you will be asked to sit up and sip liquids.
After the surgery you will probably be able to go home the same day. Have an adult family member take you home.
You can return to the normal activities within 24 hours after the surgery.

Call your doctor if:

  • You have pain unrelieved by medication
  • You develop persistent nausea and vomiting
  • You develop fever
  • You experience a significant reduction in vision
  • You develop unusual symptoms
What precautions must a patient take after phacoemulsification ?

After the cataract surgery, you need to follow certain precautions at home to help you in a fast recovery.

  • Do not read or watch TV for a few days
  • Put the eye drops and other medications as prescribed by your surgeon
  • Avoid getting soap water or dust into the operated eye
  • Use shaded glasses for a week after the surgery
  • Avoid sleeping on the side of the surgery for a week.
  • Avoid rubbing and putting pressure on the operated eye.
  • Avoid strenuous exercise and avoid lifting heavy objects. Avoid bending over.
  • Clean the eyes when there is a discharge of tears. Clean the area around the eye, upper and lower eyelids with sterile gauze or cotton balls.

Q. If I have cataract of both eyes, will the doctor treat both the eyes at the same time?
A. The surgeon may advise surgery for the second eye after a gap of 1 to 4 weeks.

Q. When will my vision improve after the surgery?
A. You will be able to see clearly the day after the surgery.

Q. When can I start driving after the surgery?
A. You can drive in the daytime. Avoid driving at night for a while till there is complete healing.