CATARACT SURGERY – PHACOEMULSIFICATION
In the past, cataract surgery was not performed until the cataract had become well developed.
Newer techniques, however, have made it safer and even more efficient to operate in earlier
stages. In general, even if cataracts are diagnosed, the decision to remove them should be based
on the patient's own perception of vision difficulties and needs and the effect of vision loss on
Indications for Surgery
In general, surgery is indicated for people with cataracts under the following circumstances:
The Snellen eye test reports 20/40 or worse, with a cataract being responsible for vision loss
that cannot be corrected by glasses.
Performing everyday activities has become difficult to perform to the point that independence
is threatened, or the patient is at risk for accident or injury.
Some people with eye tests of 20/40 or better might want surgery because of problems with
glare, double vision, or the need to have an unrestricted driver's license.
Even if the criteria for surgery are not met, if retinal disease is also suspected (usually a
complication of diabetes cataract surgery may be performed in order to have a clear view of
Preparation for Surgery
Cataract surgery in delhi is usually done as an outpatient procedure under TOPICAL anesthesia
and takes less than half an hour. It is a stitch less , bandage less surgery. Preoperative
preparations may include:
General physical examination especially in patients with Diabetes
Boimetry- painless ultrasound test to measure the length of the eye and determine the type of
replacement lens that will be needed after the operation. (Biometry)
Topical antibiotics (such as ofloxacin or ciprofloxacin) may be applied preoperatively to
protect against postoperative infection.
All cataract procedures, cataract surgery in delhi, involve removal of the cataract-affected lens
and replacing it with an artificial lens.
Phacoemulsification (phaco means lens; emulsification means to liq uefy) – modern cataract
The procedure generally involves:
The surgeon makes a small incision usually between 1.8 to 2.8 mm.
A thin probe that transmits ultrasound is then used to break up the clouded lens into small
The tiny pieces are sucked out with a vacuum- like device.
A replacement lens is then inserted into the capsular bag where the natural lens used to be. In
most cases, this is an intraocular lens (IOL), which is foldable and slips in through the tiny
Because the incision is so small, it is often watertight and does not require a suture afterward,
particularly if a foldable lens has been used. A suture may be needed if a tear or break occurs
during the procedure or the surgeon inserts a rigid lens that requires a wider incision.
Replacement Lenses and Glasses
With the clouded lens removed, the eye cannot focus a sharp image on the retina. A replacement
lens or eyeglasses are therefore needed. In about 90% of cataract operations, an artificial lens,
known as an intraocular lens (IOLs), is inserted. IOLs are designed to improve specific aspects
of vision. The choices include:
Monofocal lenses-Lenses that address a single fixed focal point. Such lenses are suitable
either for reading or distance vision, but not both.
Multifocal lenses- Multifocal lenses can focus at different points for both reading and distance
TORIC lenses -To correct astigmatism
Complications of Cataract Surge ry
Modern cataract surgery is one of the safest of all surgical procedures. Most complications, even
if they occur, are not serious. They can include:
Swelling and inflammation.
Glare from light scattering at the edges of the new lens.
Materials used in some lenses trigger an immune response in some patients. This ca uses
inflammation and tiny deposits of tissue in the eye that lead to secondary cataracts -- called
posterior capsule opacification.
Retinal detachment Risk is very low (0.1%)
Phacoemulsification does have some specific complications, although they are rare, particularly
with experienced eye surgeons. They include:
Rupture of the lens capsule.
Loss of the lens nucleus into the eye fluid. (This will require removal by a specialist and may
result in poorer vision.)
Flying fragments of the lens can damage the cornea or threaten the retina.
Pre- and postoperative changes in blood pressure, which are generally not a problem, should
be observed carefully, since in some cases the changes may be extreme.
Cataract surgery is usually a day care procedure
The patient is usually examined the day after surgery and then during the following month.
Additional visits occur as necessary.
Vision usually remains blurred for a while but gradually clears, usually over 2 - 6 weeks.
When the doctor decides the condition has stabilized, the patient will receive a final
prescription for glasses or contacts.
Prescribed eye drops include : Steroid –antibiotic combination , an eyedrop to control
pressure inside the eye , NSAID eyedrops and a lubricating drops.These medicines have to be
taken for atleast 6 weeks and tapered accordingly in the follow-up visits.
Vision Eye Centre
Address: 19,siri Fort Road , New Delhi-110049
Phone: 011- 26267611-17
Fax: 011- 26267618
Address: 12/27, west patel nagar , near arya samaj mandir, new delhi-110008
Phone: 011- 25882129, 25887228
Fax: 011- 25881212