Procedure for Phaco indian (Hydrophilic/Hydrophilic)

Hydrophilic Phacoemulsification Emulsification

When the lens of the eye which is usually transparent becomes cloudy or opaque it is called cataract. The condition is due to the clumping of the lens proteins thus resulting in blurred vision. Cataract is the normal ageing of the lens. It usually starts at the age of forty and intensifies as the patient reaches sixty. The decrease in vision is gradual and painless in cataract.

Types of Cataract
There are two types of cataract namely,
Immature cataract: some vision is present and the lens is translucent.
Mature cataract: lens is opaque and vision is severely compromised at times resulting in blindness.
Symptoms of Cataract
Patients may experience following signs/symptoms of cataract:

• Blurry vision
• Double vision
• Fading of colours
• Seeing halos around lights
• An increased sensitivity to glare

Types of Cataract Surgery
The following are the different types of cataract surgery:
A. Phacoemulsification Surgery:
B. Femto Laser Cataract Surgery
C. Zepto Pulse Cataract Surgery

Types of lenses
The following are the different types of lenses:

• Monofocal lenses: for distant vision
• Multifocal lenses : for both near and distant vision
• Toric lenses: for astigmatism

The IOL are further classified based on their rigidity:

• Rigid PMMA lens
• Foldable: modern cataract surgeries use these as IOLs and they are better suited. These are

• Hydrophilic material: Economic compared with Hydrophobic and are soft. Indian companies manufacture these lenses.
• Hydrophobic material: Expensive but favoured. US based companies manufacture these IOLs.

Procedure of Cataract Surgery
Each eye operation should be scheduled separately when cataract affects both eyes.
Pre-surgery check up for cataract:

• Routine check up
• Any medical history of diabetes and hypertension is noted.
• Complete eye examination

Cataract surgery is done under local anaesthesia.

• Regular Phacoemulsification Cataract Surgery

In this technique, the cataract is removed with the help of ultrasonic energy. Ultrasound waves are passed which break down the lens. This process is called Phacoemulsification. The lens might be removed in one piece or broken down into pieces and extracted through the needle. The lens capsule which surrounds the lens is left intact. Through this incision, a foldable IOL is injected. The IOL opens up once inside the eye. Since, it seals itself sutures are not required. Slightly hard lenses are used in Regular Phacoemulsification. In Micro Phacoemulsification the incision is 2.2mm and soft lenses are used.

• Technique of Laser Eye Surgery

In this procedure, Laser is used and on to the computer screen live continuous 3-D OCT pictures are streamed. All incisions are marked on the computer screen including Astigmatic control incisions. The laser completes all the steps that are otherwise done by hand. The time taken for Laser is approximately 45 seconds. An IOL is inserted after aspirating the fragmented material.

Advantages of laser surgery over regular Phacoemulsification surgery:

• Precise and accurate unmatched by human hands
• Safer than regular Phacoemulsification
• Blade-less Cataract Surgery
• Improves vision better than Phacoemulsification
• Better wound sealing than Phacoemulsification  
• Premium Intra-ocular lenses can only be done by Laser

Statistics of Cataracts

Cataracts account for approximately 42% of cases of blindness. Intraocular lens are used in 99% of the patients. Laser surgery has a 98% success rate.

Required Hospital Stay
The procedure takes about 30 minutes. The patient is discharged within an hour of surgery.
Indications of Cataract Surgery
The following are the indications of Phacoemulsification and Laser surgery:

• Blurred vision
• Poor night time vision
• Seeing halos and bursts of light when patient looks at bright light
• Colours appear less sharp

Contraindications
Contraindications of Phacoemulsification and Laser surgery are:

• Macular degeneration
• Glaucoma
• Retinal detachment

Complications/Risks Associated with Phacoemulsification (Hydrophilic)

The following are the Cataract surgery complications:

• Dry eye
• Peripheral light flashes and increasing floaters
• Posterior vitreous detachment
• Intra-operative Floppy Iris syndrome
• Posterior Capsule Opacification
• Oedema of retina or cornea

Cataract Surgery Recovery
Since eye is one of the most critical parts in a human body, it is very essential for patients to adhere to measures like

• Dark eye goggles are prescribed for 7 days.
• Patient should refrain from straining the eye.
• Patient should avoid lifting weights and bending.
• Patient should avoid straining in toilet or holding breath.