CATARACT SURGERY
 

The primary treatment for cataracts is surgical removal. Cataract surgery is a highly effective and common procedure performed by ophthalmologists. The surgery involves removing the clouded natural lens of the eye and replacing it with an artificial intraocular lens (IOL) to restore clear vision.

Modern day cataract surgery is primarily performed using machines to break-down the cloudy and solidified lens matter and replace it with a foldable artificial intraocular lens (IOL) . These two techniques used in modern-day cataract surgery are namely, phacoemulsification and femtosecond-laser assisted cataract surgery. 

 

• Phaco-emusification- it is the current standard surgical technique used to remove cataracts from the eye. It is the most common method of cataract surgery and has largely replaced older, more invasive procedures. Phacoemulsification involves the use of an ultrasonic device to break up and remove a cloudy lens (cataract) from the eye, allowing for the implantation of an artificial intraocular lens (IOL) to restore clear vision. At AcuraVision Clinics-Roop Netralaya , we pride ourselves to be the leaders in this technique. Having introduced phacoemsulification to this region in the year 1994, Dr. Roop is a world renowned phacoemulsification surgeon. He was awarded for his pioneering technique by the American Society of Cataract and Refractive Surgery(ASCRS) , Chicago, 2008. 
   

• Laser assisted cataract surgery- BLADE-FREE, ROBOTIC cataract surgery using AI- technology  
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Femto laser-assisted cataract surgery (FLACS) is an automated surgical procedure where the surgical steps are essentially performed by a robot . This robot utilizes the femtosecond laser to create the space where the artificial lens is placed , creates extremely fine incisions, and breaks down the cataractous lens using the laser itself. With all the surgical steps being essentially performed by the robot , the surgeon only has to program the robot and supervise the correct execution of the steps. 

 

To know about this blade-free , safest and most precise way of cataract surgery , read more here. ( link to robotic cataract surgery) 

 

Other technologies in cataract surgery 

 

Zepto or CAPSULaser

 

These procedures or surgical aids are an adjunct to phacoemulsification . These technologies aid in safer cataract surgery by helping to perform the capsular rhexis accurately, which is one of the six important steps of cataract surgery . They should not be confused with robotic cataract surgery. These technologies are more often utilized in cases where patient may not be able to follow simple directions during the surgery and the cataract surgery is performed under general anaesthesia or local anaesthesia. Your ophthalmologist can provide more information on the utility of these for your eye surgery. 

 

Intraocular Lens ( IOL ) 

 

The aim of modern day cataract surgery is to remove the natural cloudy lens from the eye and implant an artificial clear lens in its place . This artificial lens, known as, the intraocular lens provides clear vision to the patient by removing the obstacle to the passage of light  and restoring the power of the focusing system of the eye. It is thus a standard practice to implant an intraocular lens in every cataract procedure, unless it is not suitable in some rare eye conditions . 

 

The quality of vision that one experiences after cataract surgery depends on the optical qualities of this intraocular lens . Hence, it is imperative to actively understand the various options of lenses and choose a lens that best serves your needs. 

 

Intraocular lenses are divided into various categories depending on their optics and the range of vision they provide :

 

• Monofocal Aspheric IOL : These are the most common type of intraocular lenses used in cataract surgery .  They have a single focussing power which is targeted to bring distant objects to clear focus. This means that one may not require to use spectacles for routine activities such as driving or performing daily chores. However, as the need to look at closer objects arises , the vision becomes progressively out of focus and blurred. Thus, the need for spectacles is felt routinely while performing tasks in the kitchen, reading tasks or while browsing the phone. They are known for their good quality of vision and contrast sensitivity. 
   

• Toric IOL : These lenses are designed with an inherent cylindrical power incorporated in the lens . They differ from non-toric or monofocal aspheric lenses as they are able to correct the cylindrical power or astigmatism . This allows for better distance vision in those patients who have higher cylindrical powers in their eye. Using a toric lens is not a choice but a requirement depending on the pre-operative assessment of your eye. Toricity may be incorporated in a monofocal IOL , or it may be coupled with other advanced optics such as the ones discussed below. 
   

• EDOF IOL : EDOF or Extended Depth of Focus IOLs are designed to provide a longer focus of light as compared to a monofocal aspheric IOL . As a result , they may offer variable  degree of spectacle independence in modern day lifestyle. Typically, one does not require to use spectacles for intermediate vision tasks such as looking at the computer screen. However, for reading , or performing finer tasks of near vision, spectacles are required. Usually,  the quality of distance vision is only marginally reduced compared to a monofocal lens , but in some cases this may be grossly affected leading to disturbing symptoms. 
   

• Trifocal IOL : These multifocal IOLs are designed to provide complete spectacle freedom with a range of vision that covers all tasks from distance to near . However, while these are lenses provide maximum spectacle independence , a significant minority of patients experience disturbances in quality of vision. The optics of these lenses is such that patients may experience disturbing glare , ghosting or doubling , star bursts and haloes which compromise quality of distance vision . 
   

• Panfocal IOL : These latest generation of spectacle independence lenses provide a complete range of vision and spectacle freedom while maintaining excellent quality of vision . These lenses also provide complete spectacle freedom while preserving quality of vision. With a visual quality comparable to monofocal aspheric lenses during daytime,  minority of patients may experience haloes during the night. The lenses provide a lifestyle and visual experience very close to the natural vision quality and are fast becoming the choice of lens for spectacle freedom. 

 

The decision to undergo cataract surgery, the type of procedure and the type of lens must be decided by you in consultation with your doctor. 

 

Take our quiz and know which IOL would suit your needs the best : 

 

• offers several potential advantages over conventional phacoemulsification cataract surgery (phaco). However, it's essential to note that the decision between FLACS and phacoemulsification should be made in consultation with your ophthalmologist, and the choice may depend on individual factors and the surgeon's expertise. Here are some potential advantages of FLACS :
   

• Enhanced Precision: The use of a femtosecond laser allows for highly precise incisions in the cornea and a perfectly circular and accurately sized capsulotomy (opening in the lens capsule). This precision contributes to more predictable surgical outcomes.
   

• Reduced Energy Usage: FLACS reduces the amount of ultrasound energy (phacoemulsification) needed to break up and remove the cataractous lens. Reduced energy usage is beneficial in terms of minimizing the risk of thermal injury to surrounding tissues and reducing post-operative inflammation.
   

• Customization: FLACS can be customized to match the patient's specific eye anatomy and the type of intraocular lens (IOL) being implanted. This customization can lead to optimized visual outcomes.
   

• Reduced Risk of Complications: Studies suggest that FLACS have a lower risk of certain complications, such as anterior capsule tear or IOL dislocation, compared to traditional phacoemulsification.
   

• Astigmatism Correction: FLACS can be used to correct astigmatism by making precise incisions in the cornea. This improves visual outcomes and reduces the need for glasses after surgery.
   

• Reduced Surgeon Variability: FLACS reduces variability in surgical technique because many of the critical steps are performed by the laser, which follows a predefined treatment plan. This can be particularly advantageous in complex cases.
   

• Potential for Premium IOLs: FLACS may be preferred when implanting premium IOLs, such as multifocal or toric lenses, which require high precision for optimal results.

 

Our center takes immense pride in offering the most cutting-edge and advanced technology in cataract surgery, including the world's fastest Femtosecond Laser-Assisted Cataract Surgery (FLACS) machine, the Ziemer Z8 Femto LDV. Equipped with groundbreaking innovations, it uses artificial intelligence and precise laser to treat your cataracts. Its unmatched speed allows for swift and accurate incisions, capsulotomies, and lens fragmentation, resulting in significantly reduced surgical time and enhanced patient comfort. With the Z8, our surgical team can achieve unrivaled outcomes, ensuring that our patients experience minimal downtime and rapid visual recovery.