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” At Insight eye clinic we have restored vision in thousands of
patients requiring cataract treatment.”
What is a cataract?
The location and density of the “cloud” determines the amount of vision loss. There are no medications, eye drops, exercises or glasses that will cause cataracts to disappear once they have formed. Initially, a change in your eyeglass prescription may help to improve your vision if the blurring is mild. As the cataract develops, the blurriness may keep you from doing the things you like to do such as reading, driving, and watching television. At this time, surgery is the only way to remove a cataract and to restore vision.
What is a cataract?
- Blurred or dimmed vision (particularly at night)
- Cloudy vision
- Sensitivity to light and glare
- Visual distortions or “ghost images
- Difficulty reading or driving
The only way to effectively treat cataracts is with cataract surgery.
At Insight eye clinic we have restored vision in thousands of patients requiring cataract surgery.
Modern Cataract surgery is a microsurgery; where in a tiny incision (2.2 or 2.8mm) is made on the side of the cornea. Through this incision the doctor inserts a tiny probe, using high frequency ultrasonic waves (phacoemulsification), the cataract is broken up & removed from the eye via the fine probe. Once the lens has been removed, an artificial lens is inserted through the small incision. This lens unfolds inside the eye into the correct position.
Cataract surgery is one of the safest and most commonly performed surgeries. At insight eye clinic, the surgery is performed on an outpatient basis and the cloudy lens is removed from the eye through microscopic surgical incisions using ultrasound power. Typically these incisions heal without the use of stitches. The focusing power of the lens is then restored by replacing it with a permanent lens implant.
At insight eye clinic we offer state-of-the-art cataract surgery for our patients. Your surgeon is highly trained in the safest and most advanced “no-stitch” cataract surgery for rapid visual recovery. Your surgeon will take the time to learn about your visual needs in order to develop a customized surgical plan for you.
How do I decide whether to have cataract surgery?
Your decision on whether to undergo cataract surgery will depend on your answers to the following two key questions:
- Does your vision limit your activities?
- Are you willing to have an operation?
- The Doctor will examine your eyes and determine how much the cataract is contributing to your loss of vision and decide whether there would be benefit in removing your cataract.
If you are suffering from these symptoms you may need a comprehensive eye examination to determine if you have cataracts. When cataracts are first discovered, they may not be advanced enough to cause any significant vision problems. In this scenario, your ophthalmologist may elect to monitor your cataracts without considering surgery.
When cataracts become more advanced, they may begin to affect your ability to drive, watch television, read, or perform your daily activities. At this point it may be necessary to treat your cataracts. The only way to effectively treat cataracts is with cataract surgery. There are no eye drops or pills that have been clinically proven to reverse the effects of a cataract.
If you have a diagnosis of cataract or if you think you may have cataract, then give us a call at the Insight eye clinic to schedule a comprehensive eye examination. Our highly trained surgeon has restored vision in thousands of patients requiring cataract surgery.
Possible Complications of Cataract Treatment
Cataract surgery is successful in greater than 95% of cases, but complications can occur, and can have permanent effects. The visual outcome of cataract surgery will also depend on the condition and health of your eye. Before your surgery Dr Jadhav will discuss the risks, potential benefits and expected outcome in detail with you. Serious complications are rare, but may include: infection inside the eye (endophthalmitis) which may lead to blindness and very rarely, loss of the operated eye; the risk of endophthalmitis is less than 1 in 10000.As per the protocol we routinely inject antibiotics though the existing wounds at the end of the operation, which has been shown to dramatically lower the risk of infection.
- Swelling and clouding of the cornea.
- Retinal detachment.
- Retained lens fragments requiring a second operation for removal.
- Pre-existing eye conditions such as glaucoma, macular degeneration or corneal scarring can continue to interfere with vision after otherwise successful cataract surgery.
- Endophthalmitis – infection inside the eye which can cause permanent vision impairment.
- Cystoid Macula Oedema – swelling of the macula from its normal position causing blurring vision.
- Posteriorly dislocated lens material – lens material may fall into the vitreous cavity causing pressure pain and blurred vision.
- Choroidal Hemorrhage – bleeding in the retina causing permanent visual blurring.
- Post-operative Glaucoma – increased pressure inside the eye causing pain and Smokey vision.
- Unexpected refractive outcome – the focus of the eye requires spectacles for sharpness.
Premium IOL Implants
The natural lens of the eye has the ability to shift in its focusing strength in order to allow clear vision at a wide range of distances. This ability to change the focusing power of the eye is called accommodation. Age-related changes not only cause clouding of the natural lens (i.e. cataracts), they also cause a stiffening of the lens which results in a loss of accommodation. This age-related change is termed Presbyopia and it limits the eyes’ ability to focus on near objects. This loss of accommodation is the reason that most people need to wear bifocals or reading glasses starting in their early 40’s.
During cataract surgery, the natural lens of the eye is removed with the utmost precision, and a clear replacement lens is implanted into the eye. Although the traditional lens implant improves vision after cataract surgery, it is Monofocal, meaning it is limited to clear vision at one fixed range of distance, typically far distance. This type of lens implant does not address Presbyopia. In this scenario, a pair of glasses would be needed to provide clear vision at intermediate (i.e. using the computer) and near (i.e. reading a book) distances. In the last few years, there have been exciting technological advancements that may reduce patients’ reliance on their eyeglasses.
With modern instruments and formulae most patients are able to avoid or minimize the need for glasses. A number of Toric and multifocal IOLs are now available that are designed to allow better vision without glasses as well. These IOLs are not suitable for all patients. There are IOL options that can reduce or even eliminate the need to wear glasses for near visual tasks. No single lens works best for everyone. After consultation and discussion with doctor the right course of treatment and appropriate lens for you will be determined.
There are two methods of reducing dependence on near vision spectacles after cataract surgery or refractive lens exchanges with intraocular lenses (IOLs).These are 1. Monovision with monofocal or toric IOLs 2. Multifocal IOLs.
Monovision is where one eye can see clearly in the distance and the other eye is intentionally made short-sighted so that it has either near reading vision (full monovision) or intermediate (arms length) distance vision (limited monovision or mini monovision)
It is a good option for those who have successfully practiced monovision with contact lenses and are happy with it. If you have higher amounts of astigmatism this can be neutralized by using a monofocal toric IOL, combined with monovision this can be a good option to reduce the need to wear near vision correction. It is a compromise because the distance eye does not read without glasses and the near eye cannot see in the distance. There may still be times when top-up glasses will be required such as: driving a car in poor light conditions, particularly when it is raining, Prolonged reading, as it can be tiring to read with only one eye.
The main advantages of monovision are that using modern aspheric monofocal IOLs or toric IOLs usually gives good optical quality without halos, ghosting or glare. With monovision you can still wear glasses that correct both eyes for distance or both eyes for near vision and achieve good optical quality. Achieving monovision with monofocal IOLs or toric IOLs is cheaper than using either multifocal or accommodating IOLs. Aspheric IOL’s correct for aberrations resulting from a change in curvature between the centre and edge of the pupil. These aberrations can cause multiple focal points and thus blurry vision.
If you have an active lifestyle or if you want versatile vision by reducing your dependence on glasses, then we can tailor your surgical plan to your visual demands with cutting edge lens technology. It is important to note that the following lifestyle lens options are typically not covered by either Mediclaim or private insurances. As such, these options will incur an out-of-pocket charge.
Many cataract surgery patients have an underlying asymmetry in their cornea that is termed as astigmatism. This asymmetry in the cornea can cause blurry vision, and it is commonly treated with either glasses or contact lenses.
Insight eye clinic offers two different ways to treat astigmatism during your cataract surgery so that you may be able to achieve clear distance vision without glasses:
1. Limbal Relaxing Incisions
This technique involves the use of incisions that re-shape the cornea’s contour. These incisions are precisely placed at the time of your cataract surgery, and they are more effective in patients that have a smaller amount of astigmatism. One drawback of this technique is that sometimes the effect of the incisions can wane over time.
2. Toric Intraocular Lens Implants
A toric lens is a specially designed lens that neutralizes the astigmatism in the cornea. The lens is placed in a precise orientation during the time of the cataract surgery based on your pre-operative corneal measurements. The advantages of this lens are that it can correct larger amounts of astigmatism, and its astigmatism-correcting effect is usually more permanent in nature than Limbal Relaxing Incisions. Due to the possibility of a change in the alignment of the lens, a small percentage of patients may need a re-adjustment of the lens in the weeks following cataract surgery.
PCO is treated by a minor laser procedure known as laser capsulotomy. Your surgeon uses a YAG laser to make a small hole in the central part of the posterior capsule, behind the intraocular lens and pupil. It is performed in the consulting room, is painless and only takes a few minutes.
How long does it take to recover from laser capsulotomy?
Many people notice an immediate improvement in their vision after laser capsulotomy. Normal activities can be resumed straight away following the procedure, although you should check with your surgeon regarding driving.
Is laser capsulotomy safe?
Laser capsulotomy is a commonly performed procedure with an extremely high success rate. Many people notice small spots floating in their vision for a week or two afterwards. Like any procedure there is a risk of complications that your surgeon will discuss with you, however serious side effects are rare.
A multifocal lens is an exciting new type of lens implant that allows clear vision at both near and far distances, hence reducing your dependence on reading glasses. The multifocal lens splits light rays into different zones of vision within the lens implant. The multifocal lens is implanted into the eye in the same fashion as the traditional Monofocal lens. But unlike the traditional lens which only gives the ability to focus at one distance, the multifocal lens may improve your ability to see in the distance and to read up close without glasses most of the time.
Not all patients achieve the same amount of success with the multifocal lens, and there can be variability between different patients and different eyes. Even though there is no guarantee that you will be able to read as well as you desire, the multifocal lens will give you a much better chance of spectacle independence than the traditional Monofocal lens.
Any drawbacks to the multifocal lens implant?
Although the multifocal lens may reduce your dependence on glasses, its design may cause visual disturbances. It may cause you to see halos around lights, glare and reduced contrast sensitivity in dimly lit conditions.
A small percentage of patients may have some residual nearsightedness or astigmatism after their cataract surgery.
Am I a good candidate for the multifocal lens implant?
The decision to implant a multifocal lens should come with careful deliberation on the part of both the patient and the surgeon. Certain patients with macular degeneration and advanced glaucoma are not good candidates for the multifocal lens.
