Cataract Surgeries

What is cataract?

A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. The lens is contained in a sealed bag or capsule. As old cells die they become trapped within the capsule. Over time, the cells accumulate causing the lens to cloud, making images look blurred or fuzzy. For most people, cataracts are a natural result of aging. In fact, they are the leading cause of visual loss among adults 55 and older. Eye injuries, certain medications, and diseases such as diabetes and alcoholism have also been known to cause cataracts.

A cataract is a cloudy area in the lens of the eye. A normal lens is clear and focuses light into the back of the eye. When a cataract develops some of this light is blocked out and or scattered. As this cataract develops, it becomes harder for a person to see.

Most people with cataracts have a cataract in both eyes. However, one eye may be worse than the other because each cataract develops at a different rate.

What Are the Symptoms of a Cataract?

Here are some signs of a cataract:

  • Cloudy, fuzzy, foggy, or filmy vision.
  • Changes in the way you see colours.
  • Problems driving at night because headlights seem too bright.
  • Problems with glare from lamps or the sun.
  • Frequent changes in your eyeglass prescription.
  • Double vision.
  • These symptoms also can be signs of other eye problems.

How is a Cataract Treated?

A change in your glasses, stronger bifocals, or the use of magnifying lenses may help improve your vision and be treatment enough. With time glasses will no longer work. The way to surgically treat a cataract is to remove the lens and replace it with an artificial lens.

Just because you have a cataract does not mean it must be removed immediately. Cataract surgery should be put off until you are no longer satisfied with the way you see. We don’t do cataract surgery on eyes that see well.

Most people have plenty of time to decide about cataract surgery. Your doctor cannot make your decision for you, but talking with him can help you decide if you are ready for surgery on not.

Cataract surgery:

There are two types of surgery to remove lenses that have a cataract:

Extra capsular surgery: 

  • The eye surgeon removes the lens, leaving behind the back half of the capsule (the outer covering of the lens).

After Cataract surgery
Phacoemulsification:

In this type of extra capsular surgery, the surgeon softens the lens with sound waves and removes it through a needle. The back half of the lens capsule is left behind. A person who has cataract surgery usually gets an artificial lens or implant at the same time. A plastic disc, called an intraocular lens, is placed in the lens capsule inside the eye. Your doctor will help you to decide which choice is best for you.

The power of IOL is calculated using advanced technology called ZEISS IOL master to avoid wearing glasses for distance post operatively.

Types of Intra Ocular Lenses (IOL)

The Intra Ocular Lens usually replacing the cloudynatural lens of the patient’s inside eye which is known as cataract. Most of the IOLs implanted today are Monofocal which will correct distance vision. However other types of IOLs also available in Dr. Haifa’s Eye Hospital such asToric IOL which corrects Astigmatism, Multifocal IOLs and Accommodating IOLs which provide the patient with multifocused vision at far, intermediate and reading.

Can a Cataract Return?

A cataract cannot return because all or part of the lens has been removed. However, in about half of all people who have extra capsular surgery or phacoemulsification, the lens capsule becomes cloudy. This cloudiness of the lens capsule, if it occurs, usually develops a year or more after surgery. It causes the same vision problems as a cataract does. The treatment for this condition is a procedure called Yag Capsulotomy. The doctor uses a laser (light) beam to make a tiny hole in the capsule to let light pass. This surgery is painless and does not require a hospital stay. Most people see better after YAG Capsulotomy

Posterior capsule thickening Clear view after Capsulotomy behind the artificial lens

Is Cataract Surgery Right for Me?

Most people who have a cataract recover from surgery with no problems and improved vision. In fact, serious complications are not common with modern cataract surgery. This type of surgery has a success rate of 95 percent in patients with otherwise healthy eyes. If you have a cataract in both eyes, experts say it is best to wait until your first eye heals before having surgery on the second eye. If the eye that has a cataract is your only working eye, you and your doctor should weigh very carefully the benefits and risks of cataract surgery.

Pre – operative instructions:

  • The patient should be fasting 8 hours prior to the surgery time for general anesthesia and 5 hours prior for Local anaesthesia
  • Should be in hospital at least 1 hour before the surgery.
  • For diabetic patient, any medication for controlling the blood sugar should be stopped (injections and tabs)
  • For other disease rather than diabetes (hypertension, heart and thyroid) will continue on their medication on time and using a small quantity of water with pills (1/4 cup of water). Then continue their fasting unless patient is advised by the doctor to stop the medication.
  • It is preferable that the patient accompanied by relatives or friends as he will not be able to drive or walk alone after the surgery.
  • The patient should continue fasting at least for 4 hours after the surgery. Patient using warfarin or aspirin should inform the doctor before the surgery.

Post – operative instructions:

  • Attending the clinic next morning to the surgery.
  • Keep the eye open or closed as the surgeon advised.
  • Redness in the eye is normal and will subside with the time.
  • Avoid rubbing the eye even if it is bothering you.
  • Try to have some rest in the days following the surgery.
  • Avoid any heavy physical activity that may affect your eye (attending the gym, lifting heavy weight and sexual activities) at least 2 weeks from the surgery.
  • Avoid long bed rest and walking is of benefit.
  • If the eye drops finished before the time set by the doctor, you can repeat it.
  • There is no specific diet. But healthy food like fruits, vegetables and milk products are advised.
  • Avoid getting soap or water directly in to the operated eye. While you take bath, you just swab it gently.
  • You can take shower with head tilted backwards (like hair dresser washing hair) and no swimming for 2 weeks.
  • During prayer avoid prostration till the doctor advises you to do.
  • Avoid smoking and smoking area
  • Avoid coughing and constipation by treat it as soon as it start.
  • Never wipe up the eye with anything unless it closed.
  • You can watch television with other eye.
  • Vision after surgery will be differed from patient to patient

When you should call the surgeon immediately:

  • Sudden loss of vision.
  • Increase in the intensity of the pain that you used to have after the surgery.
  • Increase secretions from the eye.
  • A sudden redness that was not exists after the surgery.
  • A direct hit to the eye.

How to use the medicines:

Eye drops - Put one drop only in lower eye lid and close your eye for 2 minutes to let the eye to absorb the drugs. Avoid fast blinking as it may remove the drop from the eye.

Ointments:

Put a small amount (1cm) inside the lower lid. The warmness of the eye will liquefy it and make a layer on eye. Increase in amount of ointment will not increase the efficacy or fast healing.