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Phacoemulsification Surgery for Cataract

In this, the complete surgery is carried out through a tiny opening-microincision (less than 3 mm)-into the eyeball. A sophisticated equipment with a pencil-like probe is used to break the cataractous lens into small fragments which are then aspirated out. A special variety of IOL made of either silicon or acrylic material is folded and inserted into the eyeball through the microincision. This variety of IOL is known as foldable IOL.

Is phacoemulsification more than 30 years old and is well established as a safe procedure?
Because of the small size of incision involved, it offers a safer surgery with lesser chances of complications during and after surgery. Usually no sutures are required to close the microincision. Post-operative recovery is much faster and often the patient can resume normal lifestyle from the very next day.

Is phacoemulsification with foldable IOL costlier than conventional ‘microsurgery’?
Phacoemulsification involves use of several sophisticated equipment and consumables thus increasing the total cost of the surgery per se as compared to conventional microsurgery. However, considering the cost of recurring expenses in the long run, phacoemulsification with a foldable IOL works out more economical than conventional ‘microsurgery’.

Why are glasses necessary after IOL implant surgery?
The natural lens of the human eye has the ability to change its shape in order to focus at various distances as required, comparable to the adjustable focusing mechanism in a SLR camera. The artificial IOL material, however, has a fixed shape and power for a specific distance only, the situation being comparable to that in an ordinary ‘click-and-shoot’ camera wherein one can take clear pictures at a specific distance only. The power of the IOL is selected by your surgeon based on biometry estimations and your visual requirements. Because the IOL has a fixed power, glasses are required after cataract surgery for clear vision at all other distances.

Nowadays, a new variety of IOL known as multifocal IOLS, is fast gaining popularity. Although it can be used in selective cases, it offers fairly clear vision without glasses at near, intermediate and far distances. Multifocal IOLs are made foldable material with specially designed optics and are costlier than other varieties of IOLs.

Can cataract be treated by lasers?
Contrary to popular myth cataract surgery by lasers is still in experimental stages. As of now, phacoemulsification which utilizes ultrasound energy is the most well established method of cataract surgery.

However, there is a condition known as after cataract which blurs a person’s vision weeks or months after cataract surgery. This occurs in nearly 40% of patients undergoing conventional ‘microsurgery’ as against less than 20% in those undergoing phacoemulsification with foldable IOL. ‘After cataract’ can be treated easily by a short laser procedure on an outpatient basis. In most cases this laser treatment needs to be performed only once.

Complications in cataract surgery:
It is important to understand that complications can rarely occur during or after the surgery, some severe enough to even limit vision. Some of the serious complications are:

  • Infection
  • Bleeding
  • Secondary glaucoma
  • Retinal detachment
  • Loss of vision

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