Cataract: No longer a disease to be feared

Life after cataract surgery used to be a night-mare about two decades ago.

The patient was forced to a life behind soda glass spectacles as vision after cataract surgery would be very hazy without specs. The objects he saw through his specs would appear much larger than their actual size. Thus even with the thick glasses he would not get perfect vision.

The patient also had to take bed rest for a week. He had to abstain from work for more than a month.

A new era has dawned with intraocular lens implantation. Here an artificial lens was used to replace the opaque cataractous lens. The quality of life dramatically improved for cataract patients after the introduction of intra ocular lens. With an intraocular lens implantation the patient could get as much or even better vision than he had before he developed cataract.

In conventional cataract surgery a 10 mm opening is made into the eye to remove the opaque cataractous lens and to introduce a clear artificial lens. This opening is sutured securely after the surgery.

Cataract surgery has now gone a step further with phacoemulsification. This surgery is popularly known as key hole cataract surgery as a very small opening is made to remove the cataract and to insert the artificial lens.

Phacoemulsification uses ultrasound energy to fragment the cataractous lens into small bits. These small bits are then sucked out of the eye through a 3 mm opening. The small opening does not require sutures.

The diameter of the artificial lens which is to be placed inside the eye varies from 5.5 to 6.5 mm. To introduce this through a 3 mm opening we have to fold the lens. The lens is folded and inserted into the eye and then is unfolded inside the eye and placed within the bag which originally carried the cataract.

After phacoemulsification surgery the patient can go back home after a few hours. Bed rest is not required. Next day onwards the patient can carry out his routine activities.

Post operative hygiene is very important in any type of surgery, whether key hole or conventional. The patient must take special care to avoid dusty and crowded places. He must especially avoid contact with people suffering from cold and cough. Medicines must be applied ritually as instructed by the doctor.

If the cataract is not operated even after vision is markedly reduced, it can become hyper mature. In a hyper mature cataract lens matter leaks out and causes inflammation and increased pressure within the eye. This condition requires an emergency surgery to relieve pain. Visual recovery after an emergency surgery may not be as good as after a planned surgery.

A seventy year old man virtually becomes a 40 year old, after modern cataract surgery as far as the eye is concerned. Thus cataract is no more a disease to be feared if detected early and operated in time.