Cataract

This is derived from the word " Cataract" which means a waterfall. It denotes a pathological process wherein the naturally clear human crystalline lens turns opaque, gradually leading to a progressive diminution of the quantum and quality of vision.

The majority of cataracts are caused by degenerative ageing changes that happen to the human lens - and are hence known as senile cataracts. However cataracts also can occur due to a wide variety of other causes, like ocular trauma, old and young age diabetes, steroid abuse, and also at birth called congenital cataracts.

Irrespective of what causes cataracts, the treatment of all cataracts that produce a disability in vision is always surgical.

All types of cataract surgeries have two parts. The first part is the eradication of the pathology by removing the affected lens... And the second part, or the refractive part, which actually restores the vision back to you .. Is the implantation of the synthetic intra ocular lens.. The quality and performance of these lenses will eventually dictate the quality of vision regained after surgery.

Hence while it is important for you to have your cataract removed by the latest state of the art techniques... It is equally important that you enquire about the premium intra ocular lenses available today with your consultant so that you can have the best possible post operative visual quality.

CATARACT SERVICES

All patients diagnosed with a cataract undergo a thorough ocular evaluation and an extensive workup.
Detailed counciling sessions,with adequate chair time,are then offered to these patients.At these sessions,their lifestyle and visual needs are addressed and along with the work up  a surgical plan is drawn up ,with a view of customizing the cataract  surgery.

Cataract services offered
1.Topical phacoemulsification- without injectable anaesthesia
2.Phacoemulsification and micro Phaco emulsification.  -2.8 and sub 2.2 mm
3. Premium IOLs
         Aspheric IOLs
         Toric IOLs
         Multifocal IOLs
         Toricmultifocal IOLs
4. Traumatic cataract surgery
5.Paediatric cataract surgery
6.Secondary IOL implantation
7.addressing astigmatism and Limbal relaxing incision
8.Combined cataract extraction and keratoplasty- triple procedure
9.Combined cataract extraction with retinal surgery

Understanding the Visual Perception of a patient with Cataract.

 

Normal Vision
No cataract with astigmatism
Moderate Cataract
Dense Cataract

 

Understanding Toricity

Astigmatism is a condition when the cornea has asymmetric curvatures in different meridians. This results in a cylindrical component of the refractive error. Astigmatism can and should be corrected at the time of cataract surgery. Failure to correct it can result in blurring of vision post-operatively.

Today, IOLs are available that correct both the spherical and cylindrical component. Correction of astigmatism using a Toric IOL will result in crisper, sharper vision post-operatively. However, the patient may have a minimal residual cylinder after surgery.

The following images enable your understanding of Toricity :

Visual perception with cataract and astigmatism
Visual perception after cataract extraction and monofocal IOL implantation
Visual perception after cataract extraction and Toric IOL implantation.

 

Using a Toric multifocal IOL, one can not only correct the astigmatism and improve the quality of distance vision, but also simultaneously achieve relative spectacle independence for near.

 

Multifocal IOLs

As we get to the presbyopic age (over 40), we all require reading glasses, the quantum of which increases with age.

After undergoing a cataract extraction, the ability to read is paralysed and an addition of +2.5 or +3 would be required to enable clear near vision.

The near addition would still be required if a monofocal IOL is implanted.

 

 Implanting a multifocal IOL (with a +3 add) enables the patient to see both distant and near objects clearly. Almost 95% of all activities, for distance or near, can be easily carried out without glasses.

 

Limitations of using a multifocal IOL include post-operative glare and halos which settle over a few months.

1 Month

 

3 Months

 

5 Months

 

Using a Multifocal IOL with a +2.5 add enables better intermediate vision. One may require glasses with a small reading add for some near activities.

The glare/halo component is significantly reduced with this lens.