Sight is our most precious sense, enabling us to enjoy the beauty of the world, to see the faces of the people we love, to drive a car, to read - indeed to enjoy the world in which we live. For centuries, developing cataract doomed a person to blindness. Today modern surgical techniques allow people to enjoy clear vision after their cataracts have been removed.
Phaco surgery is the latest state of the art technique for the management of cataract. The surgery requires sophisticated equipment and high degree of surgical skills. The surgery has made the patients post operative recovery very smooth and quick. Instead of surgically producing a spectacle number as with the conventional technique, it is now possible in Phaco to correct some pre-existing spectacle number also thereby reducing the need of glasses. However do remember that it is not the machine but the man behind the machine who is to deliver the best results.

What is Cataract? What are the problems associated with Cataract? Who are normally affected by Cataract? What are the usual symptoms indicating Cataract? What should one do? What is the treatment for Cataract? What is Phaco Technique? How is this technique better than conventional technique? Is this technique more expensive than conventional stitch technique? Is there a lens which can give me good Clarity for both distance and near vision? How does the multifocal leans work? Can an immature cataract be operated by Phaco? If one eye has had a conventional cataract surgery with IOL, can Phaco be done in the other eye? What is the difference between a foldable and a non-foldable lens? What investigations are required before performing this procedure? Will I need to use glasses after Phaco? What is the cost of Phaco? Comparision between stitch & stitchless surgery.

What is Cataract? To understand cataract, one has to visualize that an eye behaves like a camera with a transparent lens focusing light on the reel of the eye i.e. retina. The picture so formed on the retina is then sent to the brain via a nerve to complete the process of seeing. When this lens starts becoming opaque or white, the problem is labeled cataract( Safed Motia). So when the lens is partially opaque, it is called an immature cataract and some light can pass through to help perform some routine functions. However, when the opacity increases to engulf the entire lens, vision is totally cut off and the cataract is mature. TOP What are the problems associated with Cataract? There is a painless progressive diminution of vision. Initially some help is achieved by changing the spectacle number, but in advance cases the spectacles also prove to be in effective. TOP Who are normally affected by Cataract? Cataract usually occurs in the elderly after the age of fifty but variations are known. Cataract can occur in the new born due to development problems. In the young, due to injury especially by arrows during the Dusshera festivalies, and in any age due to an extension of any other eye problem.        TOP What are the usual symptoms indicating Cataract? The most important symptom of cataract is a decrease in vision / sight for distance & / or near objects. Other features can be decrease vision in bright or low light, decreased contrast, glare, altered colour appreciation, seeing many images of one object, rapid changes in the number / power of glasses, or sometimes pain, redness and watering. In advanced cases there is complete loss of sight and pupil becomes pearly white in colour. However, none of these symptoms are seen exclusively in cataract. TOP What should one do? The first thing a person must do on experiencing any of these symptoms is to consult an eye surgeon (Ophthalmologist) giving details of ones symptoms and getting ones eyes thoroughly examined. Answers to the following questions should be sought : Do I have cataract ? Do I have any other eye disease ? What is the cause of cataract in my eye ? What are the treatment modalities available ? What treatment would be most suitable for me ? What is the expected outcome of the treatment/surgery in my case ? What are the risks involved and possible complications ? How long can I wait before I get operated ? What does the surgery involve in terms of time and    expenditure ? TOP What is the treatment for Cataract? There are no medicines to treat cataract. The answer lies only in surgery where the cataract is removed and replaceby an intra-ocular lens. TOP What is Phaco Technique? Currently the best accepted technique to remove cataract the world over is through Phaco-emulsification. A small 3 mm incision is placed in the eye and a hollow Phaco needle is introduced through the opening. On giving energy through the tip of the Phaco needle, the cataract lens gets dissolved and sucked out through this needle. An artificial lens called a foldable Intra-Ocular lens is now injected through this small opening. Once inside the eye, it opens up and serves to replace the original lens. Since the eye opening is very small and designed in a special manner, it seals and no sutures are required. Hence this procedure is also popularly known as ‘stitchless’ cataract surgery. TOP How is this technique better than conventional technique? The main advantages of Phaco are that a person has a good vision the very next day and may resume routine activities also the very next day. Stitches and related problems are things of the past. A person may now accomplish routine activities without spectacles, however a little spectacle correction may be required for fine focusing for distance and near. TOP Is this technique more expensive than conventional stitch technique? Hi-tech expensive equipment and disposables are required to execute a good surgery, making it a little more expensive than the conventional technique. TOP   Is there a lens which can give me good clarity for both distance and near vision?                                    Yes.These are called multifocal intracular lens and give good vision without glasses for distance and reading. However in some eye condition, a need for using a little spectacle correction may be felt for very fine work. TOP     How does the multifocal lens work? When the distance object is in focus, the near is out of focus.In the same way, when near is in focus, the distance is out of focus. Thus the patient is able to see both distance and near objects clearly. TOP Can an immature cataract be operated by Phaco?   It is easier and safer to operate on an immature cataract by Phaco. As the cataract matures, it tends to become harder requiring more Phaco energy to do the same job. Beyond a certain limit, excess energy may cause harm to the eye. TOP If one eye has had a conventional cataract surgery with IOL, can Phaco be done in the other eye? Yes. TOP What is the difference between a foldable and a non-foldable lens? Foldable Lens: This lens has a diameter of 5.5 mm and is made of either Silicon or Soft Acrylic. On folding its diameter is reduced to 2.75 mm and it can be introduced into the eye through a 3 mm incision, where it unfolds automatically to take a position. Non-foldable Lens: This lens has a diameter of 5.5 mm. A 3 mm incision has to be enlarged to 5.5 mm to introduce this lens. However the incision still remains self-sealing and requires no sutures in most of the cases. TOP What investigations are required before performing this procedure? The Blood Pressure (BP) and Blood Sugar should be in control. E C G and a medical checkup may be required in some cases. TOP Will I need to use glasses after Phaco? The lens that we use is a fixed powered lens. This is focused between the distance and the near vision more so for distance as this is the vision that is in use most of the time. As a result a person after the Phaco procedure will be able to perform routine activities without glasses. However a little spectacle correction would be required for fine focusing of distance and near vision. TOP What is the cost of Phaco? With a non-foldable lens 9500/- With a foldable lens 13500/- TOP

Stitch operation Phaco operation & non-foldable lens Phaco operation & foldable lens 1 Incision size on eye 10 m.m. 5.5 m.m. 3 m.m. 2 Incision closure With sutures No sutures No sutures 3 Spectacle no. stable 6 - 12 months 15 days 4 days 4 Starting routine activities 2 months 7 to 15 days 2 to 4 days 5 Surgical induced number 0.5 to 5.0 0.5 to 1.50 0.00 to 0.50 6 Cost Rs. 8000 /- Rs. 9500 /- Rs. 13,500 /- TOP

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