Cataracts can best be described as a clouding of the eye’s natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. Like all other living tissue in the body, old cells within the lens die and are continuously replaced with new cells. Over time, the old cells begin to block and diffuse light as it passes through the lens.

Usually natural results of aging, cataracts are the leading cause of vision loss among adults 55 and older. However, even young adults and children can have cataracts.

In much the same way as the lens of a camera focuses light on the film inside, the eye’s natural lens normally works to focus light on the retina along the inside back wall of the eye (See Clear Lens top left). Just as a dirty camera lens spoils an otherwise perfect picture, vision is impaired when the natural lens in the eye becomes clouded by cataracts. Light cannot pass clearly to the retina, and the resulting image appears blurred or “cloudy”.  

How cataracts develop?

The development of a cataract will vary from person to person, but as a general rule, most cataracts develop slowly over a period of time. A cataract can take months or even years to reach a point where it adversely affects vision. Or, in the case of a cataract resulting from an injury to the eye, it can develop rapidly, although this is rather uncommon.

The effects of cataracts and the first signs of their development can also vary. Some patients first notice a cataract as a reduction in central vision. Others may experience a problem a peripheral (or side) vision. Others still may notice a glare when looking toward a light.

(Young children and infants can also be affected.)

 How cataracts affect your lifestyle?

The most common signs of cataract developments are blurred or fuzzy vision and sensitivity to light. These symptoms often show themselves as a difficulty in driving, particularly at night. For some people, cataracts make reading difficult, especially when reading small print.

               Normal vision                                      Vision in cataract

What are the  options for treatment?

There is presently no medical treatment that will prevents cataract or reverse them once they develop. The only treatment for cataracts is their removal.

            The decision to operate is reached by you and your doctor together. This decision is based on the degree to which the cataract is impairing your vision and the effect this impairment has on your lifestyle. It is a decision only the two of you can make, and it is based on your individual needs.

            If you do opt for treatment, there are several surgical treatments that may be used. Virtually all these procedures are performed by removing the eye’s clouded natural lens and replacing it with an IOL implant. The most advanced form of cataract treatment is micro-incision surgery. The cataract treatment options are as follow.

Microincision cataract surgery is made possible through a procedure called phacoemulsification combined with advances in incision design and the foldable lens implant. During this procedure the cataract is removed through that incision. In some cases, this does not require any stitches following insertion of the foldable lens implant (no-stitch). In some cases, one stitch may be required (single-stitch). If circumstances dictate, the surgeon may use a hard, plastic lens implant, and several stitches may be needed to close the incision. Usually, the smaller the incision, the faster your recovery of vision; however, each of these procedures achieve similar results.

MICRO INCISION CATARACT SURGERY

Cataract Extraction with Phaco-emulsification and implantation of Foldable Lens

Incision approximately 3 millimeters in size

Soft, foldable lens implant

Usually performed without stitches

Conventional Cataract Surgery

Extracapsular Cataract

Extraction (ECCE)

Incision 10 to 12 millimeters in size

Hard, plastic lens implant

Multiple stitches required

Extracapsular cataract extraction (ECCE or large incision) was an earlier form of cataract surgery. It was developed in the 1970s. In this procedure, the clouded lens is removed in one piece through a 10 to 12 millimeter incision. Then a plastic lens implant is placed in the eye. In this case, recovery of vision typically takes 8 to 12 weeks.

            Many procedures today are performed with phaco-emulsification and micro incision surgery. Your surgeon will recommends the type of cataract surgery most appropriate for you. This recommendation depends in part on the density of the cataract, your eye’s total health, and other variables.

 What are the  latest Advancements ?

In the every-evolving world of medicine, micro-incision surgery is the latest advancement for cataract surgery. Designed to promote faster recovery of vision, micro incision surgery resulted from two developments in medical technology; the method of cataract removal called phaco-emulsification and the foldable lens implant.

            To most patients, the potential benefits of this micro incision usually result in little discomfort during or after surgery, a more speedy recovery, reduced risk of postoperative astigmatism (or distorted vision), and a swifter return to improved vision and normal activities. Some of the time frames for these benefits vary slightly with the type of micro incision surgery performed.

Phacoemulsification:

The first step in micro incision cataract surgery is a procedure called phacoemulsification. In phacoemulsification, ultrasound vibrations are used to break apart the cataract, fragmenting it into tiny pieces. The cataract is then removed using a suction device, leaving behind the intact back portion of the lens capsule. All this is done through an incision less than 3 millimeters in size. Although phacoemulsification has been around for several years now, its full potential was not realized until the development of the foldable lens implant. (See diagram of phacoemulsification above).

Foldable lens implants:

Making Micro Incision Possible

The development of the foldable lens implant is big breakthrough for micro incision surgery. Designed to allow the full benefits of phacoemulsification, the lens implants are made of a soft, flexible material. Their soft construction allows the lens implant to be folded for insertion through the same micro incision used during phacoemulsification. Once inside, the foldable lens implant is unfolded and set into place.

The foldable lens has been in general use since 1989. Over 5 million foldable lens implant operations have been performed since that time.

The Best Possible Vision

Foldable lens implants allow for quick recovery of vision and in many cases enhance or improve the patient’s vision. With the sophistication of foldable lens implants, surgeons can often choose a particular power of foldable lens implant following cataract removal to reduce a patient’s nearsightedness of farsightedness. This often results not only in resorted sight but also improved vision following cataract surgery.

ADVANTAGES OF MICRO INCISION SURGERY INCLUDE:

·        No distorted images

·        Safer than other cataract surgery because of the reduced risk of complications during surgery.