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Surgical options

			Surgery can be performed manually through 5- 6 mm wounds called SICS (Small Inscision Cataract Surgery).

			Phacoemulsification is at present universally accepted as the standard of care for cataract surgery.

			Ultrasound energy is used in phacoemulsification to break up the cataract (emulsify) into microscopic fragments which can be sucked out of the eye.


	Wound 5-6mm SICS		Wound 2mm Phaco

What is MICS?

			The surgical wounds have progressively become smaller and now the latest technique is "Micro-coaxial Phacoemulsification" or MICS.

			MICS is phacoemulsification of the cataract through a wound of 2.2 mm or less, with implantation of an intra-ocular lens through the same wound.

			Wound healing and refractive stabilization is faster in MICS than in traditional phaco.

Options in Intra-ocular Lenses (IOLs)

			The majority of the IOLs implanted are mono-focal.
			They can focus light rays from one particular distance only.
			Normally distance objects are clear and one needs glasses for reading.

			Intra ocular lens can be rigid or foldable. Foldable lens will need smaller wounds to insert.


	Wound 5-6mm, Rigid IOL		Wound 2-3mm, Foldable IOL

What about multifocal IOLs?

			Multifocal IOLs have different segments built onto the same lens which allows clear distance & near vision with spectacle freedom for most activities.

What about toric IOLs?

			Traditionally used monofocal IOLs correct only the spherical refractive error. Patients with pre existing astigmatism will need spectacle correction for distance vision and near. Toric IOLs eliminates the need of glasses for distance.

			Recently multifocal IOLs have also been introduced with this option, thus correcting for distance, near and cylindrical error.

What about accommodative IOLs?

			Accommodative IOLs will probably be the preferred IOL at some point in time as they mimic the natural eye at young age.

			At present the ones available give good intermediate vision (as for reading from a computer), but most people would require some glasses for reading from near.

What are the pre-op procedures?

What happens on the day of surgery?

			Surgery is a "walk in- walk out" procedure.

			Surgery is mostly done under topical anaesthesia. Anaesthetic drops numb the surface of the eye and the surgery can be comfortably and painlessly performed. The eye remains open after surgery.

			Some patients may require an anaesthetic injection before the surgery.

			A routine surgery lasts approximately 10 minutes with the preparation time being of similar duration.

			Pre-operatively dilating drops are applied which take between 1 – 1.5 hours to act.

			One could expect to spend half a day at the hospital on the day of surgery.

FAQ on Post-operative Care

Is there much discomfort after surgery?

Cataract surgery is pretty much painless and so is the post-operative period. There is mild irritation (or foreign body) sensation for a few days. There may be mild redness & watering of the eyes which again subside in a few days.

What do I do after surgery?

There is no need for bed rest after surgery. One can walk, eat normally, watch TV and be normal around home on the day of the surgery. One needs some protective glasses only when outdoors.

What about the post-operative treatment?

			There is a graded schedule for eye drops after surgery.

			No tablets / injections are used.

			One would start with 3 types of eye drops, which would be stopped over a period of 6 weeks

When can I resume my normal work?

			One can resume work even the day after surgery.

			One could either work from home or office, but one should remember to apply the drops as advised.

			Normally till the glass correction is given 4-6 weeks after surgery, reading may be difficult, but this is much better after implantation of a multifocal IOL.

			Temporary glasses can be given the day after surgery.

			One could resume routine exercise, yoga & sports like golf 2-3 days after surgery.

What about post-operative restrictions?

			One should avoid water from directly getting into the eyes for 10 days after surgery.

			One could sponge the hair and face properly even the day after surgery.

			Normal bathing (taking precautions for the eye) can be resumed the day after surgery.

			After 10 days one can be completely normal.

			Bending down, chewing food or lifting moderate weights are not at all a problem after surgery.

			One can be pretty much normal after surgery.

When will I see well?

			The vision will be bright and pretty much clear the day after surgery.

			Full vision will be restored gradually in a few days time.

			Objects may appear excessively bright & blue in colour for some days. This is because the cataract was not allowing light to reach the retina and most of the blue light was being cut off. The brain gets disused to seeing blue. All these complints are temporary.

Will I need glasses after surgery?

			We use highly specialized equipment (Immersion A-Scan, Optical Biometry, corneal topography etc.) to predict the IOL power to be implanted.

			Even then, there is a small possibility of a minor error in the IOL power. This leaves a residual spectacle power which would need to be corrected with glasses.

How do I clean my eye after surgery?

			One would not normally need to specifically clean the eye after surgery.

			Mopping the face with a wet towel (with the eyes closed) should suffice.

			If there are deposits of medicines on the eyelids or lashes one could use fresh ear buds, moisten them with an antibiotic eye drops and clean the outside of the eyelids (and lashes) with them.

Can I travel after surgery?

			There is no problem in travelling even on the day after the surgery.

			Any amount of travel is absolutely fine provided one remembers to apply the eye drops.

			Timings will be given for the application of the eye drops, but an hour this way or that does not cause any problem.