The department has been a pioneer in cataract extraction by phacoemulsification technique in North India, this can be attributed by the fact that we procured our first phacoemulsification machine in the early 1990's .
Over the last decade our consultants have played a key role in leading the way to Phacoemulsification of Cataract done under topical anaesthesia (NO INJECTION, NO STITCH, NO PAD).
We have held workshops (live surgery demonstration) and instruction courses in various states and also at the National Conferences.
Amongst routine cataract surgery we also have the experience and infrastructure to manage complicated cataracts and also paediatric cataracts.
Our surgeons at present have at their dispsal the third generation fully computerized phacoemulsification machine (Alcon Legacy 20000 series â) which complements their surgical expertise to offer the patients the state of the art in cataract surgery.
The foldable intraocular lenses being used are the latest available in the world.
The department is on the verge of acquiring the latest Excimer Laser machine with LASIK facility with the help of which refractive errors can be corrected, commonly known as the Laser machine to remove spectacles.
Keratometry
Hand held KeratometryWhat is a cataract?
A cataract is an opacity or cloudiness in the natural lens of the eye. It is still the leading cause of blindness worldwide and represents an important cause of visual impairment in the Indian sub continent. The development of cataracts in the adult is related to aging, sunlight exposure, smoking, poor nutrition, eye trauma, systemic diseases, and certain medications such as steroids.
Just as a smudged or dirty camera lens may spoil a photograph, opacity in the natural lens of the eye can result in a blurred image. Patients with cataracts usually complain of blurred vision either at distance, near, or both. This may interfere with tasks such as driving or reading. Other common complaints include glare, halos, and dimness of color vision.
The Procedure
Cataract surgery today is typically performed using a microincisional procedure. To the patient, this means minimal discomfort during or after surgery, a more speedy recovery of vision, and reduced risk of induced astigmatism. This means less dependence on glasses afterwards.
Below, we've detailed the major steps of cataract surgery using a microincision procedure, phacoemulsification (ultrasonic cataract removal), and a foldable lens implant. This type of procedure is considered state-of-the-art for cataract surgery today. The procedure demonstrates basic principles only, however, and eye surgeons use many variations of the general theme, even from one case to another, depending on the type of cataract being removed.
The most commonly used cataract incision is about 3 millimeters in size - just about one-eighth of an inch! Because of the careful construction of this incision, and its small size, the incision is generally self-sealing. This translates to a "no-stitch" type operation. (FIG 1)
Fig 1
Fig 2The surgeon then creates an opening in the capsule, which is a micro-thin membrane surrounding the cataract. This procedure, called capsulorhexis, requires extraordinary precision since the capsule is only about four-thousandths of a millimeter thick! This membrane is actually thinner than a red blood cell and the surgeon must delicately remove the capsule while manipulating instruments within the anteriorchamber - a space only 3 millimeters deep! (FIG 2).
Phacoemulsification is the aspect of the procedure in which ultrasonic vibrations are used to break the cataract into smaller fragments. These fragments are then aspirated from the eye using the same instrumentation. (FIG 3).
Fig 3
Fig 4The surgeon may elect to create grooves in the cataract, and subsequently break the cataract into smaller pieces using the phacoemulsification tip and a second instrument passed through a smaller "side-port" incision. (FIG 4).
The lateral view of the procedure shows the phacoemulsification tip being placed into the substance of the cataract by the eye surgeon. The "phaco" aspect of the procedure is used to remove the denser central nucleus of the cataract. (FIG 5)
Once the denser central nucleus of the cataract has been removed, the softer peripheral cortex of the cataract is removed using an irrigation/aspiration handpiece. The posterior or back side, of the lens capsule is left intact to help support the intraocular lens (IOL) implant.
Fig 5
Fig 6The intraocular lens is often folded and passed through the tiny incision where it is opened (implanted) inside the "capsular bag". In this illustration, the lens is being inserted via an "injector". This is an instrument designed to help keep the incision size small while allowing implantation of a 6 millimeter lens through a 3 millimeter (or even smaller) incision! (FIG 6)
The IOL is shown here implanted within the "capsular bag" where it is neatly centered. The springy "arms" of the IOL, known as haptics, hold the lens implant within the capsular bag. The IOL does not generally require sutures to remain in good position. (FIG 7)
Fig 7
Fig 8This lateral view of the IOL implant shows the lens within the "capsular bag," which is the desired location. This position is the same as that of the natural lens (cataract) of the eye and, therefore, is generally tolerated best and provides the most optimal visual results. At this stage, the cataract operation with IOL implantation is complete. (FIG 8)
