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Cataract Phaco
 

Normal Vision
Cataract Vision
What are cataracts?
Cataracts can best be described as a clouding of the eye’s natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. Like all other living tissue in the body, old cells within the lens die and are continually replaced with new cells. Over time, the old cells begin to block and diffuse light as it passes through the lens.
Usually natural results of aging, cataracts are the leading cause of vision loss among adults 55 and older. However, even young adults and children can have cataracts. In much the same way as the lens of a camera focuses light on the film inside, the eye’s natural lens normally works to focus light on the retina along the inside back wall of the eye (See Clear Lens top left). Just as a dirty camera lens spoils an otherwise perfect picture, vision is impaired when the natural lens in the eye becomes clouded by cataracts. Light cannot pass clearly to the retina, and the resulting image appears blurred or “cloudy”.
 
How cataracts develop?

The development of a cataract will vary from person to person, but as a general rule, most cataracts develop slowly over a period of time. A cataract can take months or even years to reach a point where it adversely affects vision. Or, in the case of a cataract resulting from an injury to the eye, it can develop rapidly, although this is rather uncommon.

The effects of cataracts and the first signs of their development can also vary. Some patients first notice a cataract as a reduction in central vision. Others may experience a problem a peripheral (or side) vision. Others still may notice a glare when looking toward a light.
Cataract can also occur due to :
 
Eye Injuries Diabetes Kidney disease Certain medications
 
(Young children and infants can also be affected.)
 
How cataracts affect your lifestyle?
The most common signs of cataract development are blurred or fuzzy vision and sensitivity to light. These symptoms often show themselves as a difficulty in driving, particularly at night. For some people, cataracts make reading difficult, especially when reading small print.
MAIN SYMPTOMS
  • Blurring of eyesight, especially in bright light.
  • Visual distortion when reading (e.g. inability to distinguish between letters).
  • Brighter and clearer vision in one eye
 
Normal Vision
Cataract Vision
 
What are the options for treatment?
 
There is presently no medical treatment that will prevent cataract or reverse them once they develop. The only treatment for cataracts is their removal. The decision to operate is reached by you and your doctor together. This decision is based on the degree to which the cataract is impairing your vision and the effect this impairment has on your lifestyle. It is a decision only the two of you can make, and it is based on your individual needs.

If you do opt for treatment, there are a number of surgical treatments that may be used. Virtually all of these procedures are performed by removing the eye’s clouded natural lens and replacing it with an IOL implant. The most advanced form of cataract treatment is microincision surgery. The cataract treatment options are as follows
 
Microincision Cataract Surgery is made possible through a procedure called phacoemulsification combined with advances in incision design and the foldable lens implant. During this procedure the cataract is removed through that incision. In some cases, this does not require any stitches following insertion of the foldable lens implant (no-stitch). In some cases, one stitch may be required (single-stitch). If circumstances dictate, the surgeon may use a hard, plastic lens implant, and several stitches may be needed to close the incision. Usually, the smaller the incision, the faster your recovery of vision; however, each of these procedures achieves similar results.
MICRO INCISION CATARACT SURGERY
Cataract Extraction with Phacoemulsification and implantation of Foldable Lens
Incision approximately 3 millimeters in size 
Soft, foldable lens implant
Usually performed without stitches
 
Conventional Cataract Surgery
Extracapsular Cataract
Extraction (ECCE)
Incision 10 to 12 millimeters in size 
Hard, plastic lens implant
Multiple stitches required
 
Extracapsular cataract extration (ECCE or large incision) was an earlier form of cataract surgery. It was developed in the 1970s. In this procedure, the clouded lens is removed in one piece through a 10 to 12 millimeter incision. Then a plastic lens implant is placed in the eye. In this case, recovery of vision typically takes 8 to 12 weeks.

Many procedures today are performed with phacoemulsification and micro incision surgery. Your surgeon will recommend the type of cataract surgery most appropriate for you. This recommendation depends in part on the density of the cataract, your eye’s total health, and other variables.

 
What are the latest Advancement?
In the every-evolving world of medicine, microinsion surgery is the latest advancement for cataract surgery. Designed to promote faster recovery of vision, micro incision surgery resulted from two developments in medical technology; the method of cataract removal called phacoemulsification and the foldable lens implant. To most patients, the potential benefits of this micro incision usually result in little discomfot during or after surgery, a more speedy recovery, reduced risk of postoperative astigmatism (or distorted vision), and a swifter return to improved vision and normal activities. Some of the time frames for these benefits vary slightly with the type of micro incision surgery performed.
 
Phacoemulsification
The first step in micro incision cataract surgery is a procedure called phacoemulsification. In phacoemulsification, ultrasound vibrations are used to break apart the cataract, fragmenting it into tiny pieces. The cataract is then removed using a suctioning device, leaving behind the intact back portion of the lens capsule. All this is done through an incision less than 3 millimeters in size. Although phacoemulsification has been around for several years now, its full potential was not realized until the development of the foldable lens implant. (See diagram of phacoemulsification above).
 
Foldable lens implants:
Making Micro Incision Possible
The development of the foldable lens implant is big breakthrough for micro incision surgery. Designed to allow the full benefits of phacoemulsification, the lens implants are made of a soft, flexible material. Their soft construction allows the lens implant to be folded for insertion through the same micro incision used during phacoemulsification. Once inside, the foldable lens implant is unfolded and set into place.
 
The foldable lens has been in general use since 1989. Over 5 million foldable lens implant operations have been performed since that time.
 
The Best Possible Vision
Foldable lens implants allow for quick recovery of vision and in many cases enhance or improve the patient’s vision. With the sophistication of foldable lens implants, surgeons can often choose a particular power of foldable lens implant following cataract removal to reduce a patient’s nearsightedness of farsightedness. This often results not only in resorted sight but also improved vision following cataract surgery.
 

Q. Is micro incision surgery considered experimental?

A. No. Millions of micro incision surgeries have been performed.

Q. Does micro incision surgery speed my recovery?

A.  Yes. Micro incision surgery, simply by the virtue of the smallest possible incision, is designed to speed the recovery of vision and reduce the restrictions on your activities after surgery.

Q. Is micro incision surgery safe?

A. Due to current technological advances, many surgeons feel that cataract surgery is safer than even before because of the reduced risk of complications during surgery. Also, this smallest possible incision reduces chances of injury and infection to eye.

Q. Does Micro incision surgery cost more?

A. No. Based on studies of micro incision surgery patients following the procedure, the total costs may even prove to be less. This is because micro incision surgery patients are less likely to require a change in their eyeglass prescription during the first year. Post-operative astigmatism is also lower. If you consider quicker recovery and better quality of life, the rewards are many folds more than the costs.

Q. Can I have micro incision surgery on one eye if I have previously had conventional cataract surgery on my other eye?

A. Yes. If your total eye health is okay, you may have micro incision surgery on your “second eye”.

Q. How soon after surgery will I able to see?

A. In some instances, you will be able to see immediately following surgery, although most patients experience clearer vision the day following surgery.

Q. If I wear corrective eyeglasses or contact lenses before cataract surgery, can I expect improved vision and restored sight?

A. Yes. In many cases, your vision following surgery will be better than ever before. This is due to the technological developments.

 
ADVANTAGES OF SMALL INCISION SURGERY INCLUDE:
 
Faster visual recovery (Quicker healing)
Less trauma to the eye reduces chances of injury and infection to eye.
Better vision
Quicker return to normal activity
Better control of surgically induced astigmatism
No distorted images
Safer than other cataract surgery because of the reduced risk of complications during surgery.
 
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