What is Cataract (Motiyabind)?

At Shroff Eye Centre, we make sure that the utmost care is taken to protect you from eye infections and other complications. Our sterilisation methods adhere to the highest norms, and we follow a thorough safety checklist for all our patients, regardless of which package you choose. Package cost varies depending upon the type of surgery and type of lens you choose. We have a wide variety of lenses, and our packages start from about ₹30,000 and ₹1.5 lakhs. The final cost of surgery will be decided after consultation with our cataract surgeons.

Most people notice that their vision gradually deteriorates – objects may begin to look dull, yellow, hazy, blurred or distorted.

Some people also report:

• Double vision, or polyopia (objects appearing multiple)
• Haloes and glare at night
• Need of more light to see clearly
• Increasing nearsightedness.
• In advanced cases, the cataract may be visible as a whitish-looking pupil.
• Have some doubts? Come visit us! Book an appointment here.

The only approved treatment for cataract is surgery with lens replacement. This is one of the commonest surgeries performed all over the world. It is safe and effective. The cataractous lens is removed and replaced with a clear lens which restores your vision.

Usually, when you start having difficulty doing your daily activities you need to have cataract surgery.

If you’re having trouble reading, watching TV, or driving, it’s time to talk to your eye surgeon about what can be done.

Modern cataract surgery can be performed successfully and safely in any season including summers and the rainy season.

It is a cloudiness or opacification of the normally clear lens in the eye.

Most people notice that their vision gradually deteriorates – objects may begin to look dull, yellow, hazy, blurred or distorted.

Some people also report:

• Double vision, or polyopia (objects appearing multiple)
• Haloes and glare at night
• Need of more light to see clearly
• Increasing nearsightedness.
• In advanced cases, the cataract may be visible as a whitish-looking pupil.
• Have some doubts? Come visit us! Book an appointment here.

Cataract prevents the lens from focusing light on the retina and hence causes unclear vision. As the cataract advances, this cloudiness of vision increases over a period of time until the vision is completely impaired.

At Shroff Eye centre, a comprehensive eye checkup and examination by an ophthalmologist on a slit lamp can determine if you have a cataract forming.

The only approved treatment for cataract is surgery with lens replacement. This is one of the commonest surgeries performed all over the world. It is safe and effective. The cataractous lens is removed and replaced with a clear lens which restores your vision.

No, however early symptoms of cataracts can be managed with new prescription glasses or contact lenses, and by wearing sunglasses to counteract light sensitivity until it’s time to have surgery.

An interesting and timely question!
Cataracts that occur due to the ageing process cannot be prevented as the ageing process itself cannot be prevented. Using the eyes for reading and similar activities has nothing to do with cataract formation. Avoiding the use of eyes will not prevent cataract.

Unfortunately, currently no drops are available to cure cataracts.

Till date as per all authentic medical research no medication exists to prevent or cure a cataract. The only known and proven treatment for cataract is surgery.

However, research is ongoing and in the future they may find a non-surgical cure for cataract!

Usually, when you start having difficulty doing your daily activities you need to have cataract surgery.

If you’re having trouble reading, watching TV, or driving, it’s time to talk to your eye surgeon about what can be done.

Modern cataract surgery can be performed successfully and safely in any season including summers and the rainy season.

Cataracts may develop slowly over many years or they may form rapidly in a matter of months. Some cataracts never progress to the point that they need to be removed.
Your ophthalmologist can help you decide on the appropriate time for removal. Most people wait until the cataracts interfere with daily activities before having them removed.

Mild cataracts often cause little or no vision problems. Your eye doctor is probably monitoring your cataract to see if it worsens and more significantly affects your vision or lifestyle before recommending surgery.

Some cataracts never reach the stage where they need to be removed. But if your cataract worsens and you begin to have trouble seeing clearly during everyday tasks, it's probably time to get cataracts removed.

Mature or advanced cataracts means that your cataract is at the last stage of its evolution and has become completely opaque leading to extremely poor vision. When you have mature or advanced cataracts you will usually require surgery in a relatively short amount of time.

In some cases the cataract may never progress enough to require treatment.
But many times, if cataracts are left untreated they become “ hyper-mature” – a condition in which the surgery becomes more challenging and more prone to complications.
Generally, for better outcomes, cataract surgery should be performed soon after vision problems develop rather than waiting many months or years.

Most patients with systemic illness such as diabetes and hypertension ( high blood pressure) can undergo cataract surgery if their parameters are under control and within acceptable limits.

We urge you to let our ophthalmologist know your detailed medical history. Our ophthalmologists will explain to you if you cannot safely undergo this procedure.

LASER cataract surgery is the latest advancement in cataract treatment. Some of the critical steps of cataract surgery that were traditionally performed using handheld instruments can be completed with the precision of a laser.
These include

• Corneal Incisions
• Capsulotomy – A precise tiny 5mm circular opening for accessing and removing the cataract.
• Nucleotomy – Softening of the hard cataract into tiny pieces, allowing for easier surgery with significantly less ultrasound energy and faster visual recovery.

• Increased Precision and greater accuracy
• Less damage to surrounding structures with gentler removal of the cataract

Most cataract patients are candidates for laser cataract surgery. Your doctor will need to examine your eyes and discuss your options in more detail during your cataract evaluation.

You can expect to be at our center for a few hours ( usually about 4-5 hours). Most patients are in the procedure room for about half an hour. The 3D imaging and laser portion of the surgery take about 5 to 10 minutes.

The vision usually begins improving in the first 3 to 4 days after surgery.
If you wear glasses due to astigmatism and don't choose a lens that corrects astigmatism and cataracts, you will still need to wear glasses after surgery. Similarly, if you wear reading glasses to help you see up close for presbyopia, and don't choose a multifocal lens, you'll still need to wear glasses after surgery as well. Make sure you talk to your surgeon about what to expect after surgery.

Depending on your needs, you can talk to your doctor about advanced-technology lenses that not only correct cataracts but also other vision issues. If you know you have astigmatism, then a toric advanced-technology lens that can correct both your cataract and astigmatic power may be your best option for seeing distant things clearly. If you have difficulty seeing things close up due to presbyopia, there are also lenses available to help you see more clearly without relying much on reading glasses. Or even if you have astigmatism and presbyopia at the same time, there are lenses which can help you.

These are often referred to as:

• Toric IOLs : correct astigmatism and cylindrical power to help you see distant objects clearly
• Multifocal IOLs : enable the person to see near(read) as well as provide distance (driving) and intermediate (computer vision) vision
• 
Multifocal toric IOLs : correct astigmatism to provide clearer distance (driving) vision and correct presbyopia for intermediate and near vision

a) Monofocal IOL –
1) Good vision for distance without glasses. 2) The Aspheric monofocal lens gives you better contrast especially in dim light
conditions, and less glare and halos.
Con: You will have to wear glasses for near
work (reading and computers).
b) Toric IOL –
Pro: 1) For correcting significant cylindrical power.
2) Sharp Distance vision without glasses.
Con: You will have to wear glasses for near work (reading and computers).

c)Multifocal IOL –
PRo: 1) Good vision for distance and near without glasses.
2) Problem of glare and haloes at night
Con: For very fine print a reading aid may still be needed
d) Extended Depth Of Focus IOL
Pro : 1) Good vision for distance and computer vision without glasses.
2) Lower chance of glare and haloes at night
Con: 3) For near vision a reading aid may be needed
e) Trifocal IOL/ Panoptix
Pro: 1) Latest Multifocal IOL’s
2) Good vision for distance, computer vision and near without glasses.
3) Lower chance of glare and haloes at night
4) Better light transmission
Con:For very fine print a reading aid may be needed.

Once the IOL is implanted in the eye, it remains in place for the remainder of one’s lifetime

The lens makes a big difference to the final vision after surgery. Check out Cataract Surgery Lens Options to learn more about replacement lens options and how to talk to your surgeon about what you want out of your cataract surgery.

It's not unusual for minor refractive errors to be present after cataract surgery. IOL power calculation is done to try and reduce one’s dependence on glasses. However a minor number may be left behind despite the best calculations. These errors may be too insignificant to warrant additional surgery but still cause some blurriness — especially for tasks like driving at night.

If you choose standard cataract surgery with intraocular lens (IOL) implantation, it's likely you will need reading glasses and possibly computer glasses or other special-purpose eyewear afterward, depending on your visual needs.

But there also are cataract surgery options that can reduce or sometimes even eliminate your need for glasses. The use of premium implantable lenses such as (multifocal IOLs can provide excellent outcomes that enable many people to be glass-free for much of their day.Another option is monovision cataract surgery.

(Book your cataract appointment and discuss with our cataract surgeons the best choice for your visual needs during your pre-op eye exam and cataract surgery consultation.

When you book the cataract surgery at SEC, an instruction booklet (including investigations) and estimate sheet will be handed over to you. Eye drops and antibiotic tablets will be started for you prior to surgery.
On the day of surgery you will have to report to the centre where your surgery has been fixed. Our team of anaesthesiologists and ophthalmologists will go through your blood test and ECG reports to ensure you are fit for surgery. Our compassionate nursing staff will help get you ready for surgery.
The surgery is usually performed either by numbing your eyes with drops or an injection. The surgery takes from 15 to 20 minutes, and you will feel little or no discomfort. During the laser portion, patients often describe seeing a scene where colors change and lights come in and out of focus.
After surgery, a protective shield and a patch will be placed over your eye. You're then shifted to our comfortable recovery area where our nurses monitor your vital signs to ensure your well-being.
The entire process takes only about 4-5 hours in the hospital and usually, you're discharged and back home the same day!
Still worried? Come see our eye specialists and feel at ease. Book your eye appointment here.

Some people will experience improved vision from the very next day after cataract surgery! But for most people, the vision clears within two or three days. You may have to use some eye drops for a while and come for a follow up visit.

While most people can resume indoor office work within a week, we request patients to avoid getting water into their eyes for about 2 weeks and avoid lifting weights or doing strenuous activity for about a.

Cataract surgery is generally regarded as one of the safest surgeries you can have. Although rare risks can include: inflammation, infection, bleeding, swelling, retinal detachment, glaucoma, secondary cataract, or loss of vision.

If you have cataracts in both eyes, surgery typically is performed on one eye, and then at least a week later it's performed on the second eye.

This approach allows the first eye to recover and your vision in that eye to stabilize before surgery is performed on the fellow eye.

Yes, it's possible to have cataract surgery if you have glaucoma.
Cataract surgery can lower high eye pressure, reducing the number of medications you need to manage your glaucoma.
Also, it may be possible for your cataract surgeon to recommend a glaucoma surgery at the same time as your cataract procedure is performed to address both conditions at once.
Additional follow-up visits may be needed for glaucoma patients after cataract surgery to more closely monitor eye pressure and adjust medications for optimum management of their glaucoma.

Cataract surgery does not typically cause dry eyes. However, patients with pre-existing dry eye may feel more uncomfortable after surgery.

Only two very small incisions are made in the cornea during the procedure. These incisions heal quickly after surgery without stitches and do not significantly affect how many tears your eyes produce.

For this reason, during your eye exam and consultation prior to cataract surgery, your eye doctor or surgeon will evaluate the tear film on your eyes. If it appears you have dry eyes, your cataract surgery might be delayed until you undergo dry eye treatment to restore a healthy tear layer on your eyes.

Removing your cataract and replacing it with a crystal-clear intraocular lens (IOL) typically will result in a dramatic improvement in the clarity and quality of your vision. Many people find this is especially true for activities like driving at night.

Minimal discomfort is typically experienced by our patients during surgery due to the use of a topical anesthetic to numb the eye.

No, you will need to arrange someone to drive you to and from your appointment and/ or surgery. This is to ensure your safety as your vision will be blurry from your eye being dilated and numbed.

In a minority of cases (perhaps 20 to 30 percent), months or years after cataract surgery, the posterior portion of the lens capsule that is left inside the eye during surgery for safety reasons becomes hazy and opaque, causing vision to again become blurred.

This "secondary cataract" (also called posterior capsular opacification) usually can be easily treated with a less invasive follow-up procedure called a YAG laser capsulotomy. In most cases, this 15-minute procedure effectively restores clear vision.

Surgery also reduces problems like glare, starbursts and halos around lights that develop as the cataract advances due to loss of contrast and scattering of light.

Modern cataract surgery is one of the safest and most successful forms of surgery. The steps of surgery are

• A micro incision of 1.8 to 2.5 mm is first made in the eyeball.
• A smooth round opening is then made in the front part of the lens capsule, which is a thin membrane enclosing the entire lens.
• All cloudy lens material within the lens capsule is then removed through the same incision by the procedure of phacoemulsification using a thin titanium probe that emits high-speed ultrasound waves, vibrating at 40,000 times per second. This breaks the cataract into tiny pieces, which are then suctioned out of the eye through the same probe.
• A Foldable Intraocular Lens (IOL) is introduced through the small incision, and placed within the capsule of the lens where it unfolds and stays in place securely.

Micro incisions such as those used in phacoemulsification seal themselves immediately after surgery and heal very quickly and allow one to return to normal work and activities within a few days. This is currently the most effective method for removing cataracts.

Your eye surgeon will be the best judge to decide whether you can undergo microincision phaco-surgery. Each patient undergoing cataract surgery at our centre is examined in detail to assess the endothelial count of the cornea using the automated Specular Microscope. Based on findings of the endothelial count by specular microscopy it may be necessary to alter certain medication used at the time of surgery. If the endothelial cell count is low we are using Viscoat to minimize loss of the already depleted endothelial cell counts during surgery.

IOL power calculations at Shroff Eye Centre are done by trained personnel and every endeavor is made so as to get very minimal post-operative power in the distance glasses.

This is done using diagnostic modalities such as immersion ultrasound and optical biometry for measuring the eye accurately before the operation. The IOLMaster is available at the centre which is capable of extremely accurate measurement of the eye and calculation of the IOL power.

Fortunately, the technological advances in IOL manufacture and surgery have made it quite safe. Complications are rare and similar ones can occur with conventional surgery without an IOL implantation.

Modern microsurgical techniques for cataract removal are highly successful procedures. The few complications that exist are becoming even more remote, with newer developments in surgical techniques and anesthesia.

Some minor complications that can occur include a slight drooping of the eyelid, swelling around the eye, corneal haze, reflections or slight distortion from the lens implant, which are usually temporary. The chances for serious complications are negligible. Possible serious complications include infection, severe inflammation, and hemorrhage.

In a majority of cases these complications can be treated successfully or may resolve on their own with a good final restoration of vision. The above list is however not exhaustive.

In conventional phacoemulsification surgery, the surgeon makes the corneal incisions with a metallic blade, and manually creates an opening in the front of the lens capsule to gain access to the cataract, and then divides the cataract with a hand held ultrasonic probe.

In bladeless cataract surgery, the Femtosecond laser is used for these three critical steps of cataract surgery, i.e. to make the incisions- the cut on the cornea, the opening in the lens capsule, and to divide the lens into fragments. Thereafter, the lens fragments are removed by the surgeon using the ultrasonic probe.

As the entire laser process is carried out under computer-guided OCT imaging

• Greater control and reliability of the incisions with regard to size, shape and location.
• Allows perfectly-shaped, perfectly-sized and precisely centered opening in the capsule to be made into the cataract lens which does not depend upon the surgeon’s skill or experience.
• Enables accurate positioning and insertion of the artificial lens implant which optimises the visual outcome. This is of utmost importance in premium intraocular lenses such as aspheric design IOLs, Toric IOLs, Multifocal IOLs and Accommodative IOLs where the slightest error can compromise the quality of vision.
• Early visual recovery- as the laser divides the lens into small fragments, the amount of ultrasound energy used to remove the cataract is greatly reduced, which in turn helps in early visual recovery.
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No surgeon in the world can perform a surgery with guaranteed results. However, almost all the patients regain good vision following cataract surgery. In certain cases, eye disease or problems in the cornea, retina or optic nerve may limit the potential for clear vision even when the cataract surgery itself has been successful.

In conventional phacoemulsification surgery, the surgeon makes the corneal incisions with a metallic blade, and manually creates an opening in the front of the lens capsule to gain access to the cataract, and then divides the cataract with a hand held ultrasonic probe.

In bladeless cataract surgery, the Femtosecond laser is used for these three critical steps of cataract surgery, i.e. to make the incisions, the opening in the lens capsule, and to divide the lens into fragments. Thereafter, the lens fragments are removed by the surgeon using the ultrasonic probe.

In both traditional cataract surgery and bladeless laser cataract surgery, microsurgical instruments are used in the operating room to remove the cloudy lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place. An intraocular lens is placed inside the eye to replace the natural lens that was removed.

It is a platform where multiple innovations and advanced technologies come together to provide unparalleled precision and safety to further improve the outcomes of cataract surgery. It consists of the following components: 1) the VERION^TM Image Guided System, 2) the LenSx^® Femtosecond Laser System, 3) the LuxOR^TM LX3 operating microscope and, 4) the Centurion^® Vision System for phacoemulsification.

The VERION^TM Image Guided System captures a high resolution image of the patient’s eye which is transferred to the operating microscope. This image is superimposed on the surgeons view. It thereby provides automated incision positioning, guidance for making the opening in the lens capsule, as well as centration and alignment guidance for multifocal and toric IOLs.

The LenSx^® Femtosecond Laser System performs the laser assisted steps of cataract surgery and includes corneal incision(s), lens capsule opening (capsulotomy), and lens fragmentation as previously described. The precision and accuracy of these steps of cataract surgery has now been further improved upon by the VERION Image Guided System. The image of the patient’s eye captured by the VERION can be directly fed into the LenSx Femtosecond laser to bring about a significant level of precision, accuracy and predictability to bladeless laser assisted cataract surgery.

The LuxOR^TM LX3 operating microscope is a top-of-the-line surgical microscope with superior illumination and depth of focus. It allows the surgeon to safely and efficiently perform all steps of cataract surgery with great ease and comfort. It allows the patients eye image as captured by the VERION to be superimposed in the surgeons view, thereby guiding incision creation, capsulotomy and precise alignment of Toric IOLs and perfect centration of Multifocal IOLs.

The Centurion^® Vision System for phacoemulsification is a state-of-the-art machine for performing microincision cataract surgery. It has a unique mechanism called “Active Fluidics^TM” technology which detects and instantaneously responds to changes in intraocular pressure (eye pressure) during surgery. This system provides unparalled safety by creating a stable environment with a consistent eye pressure throughout cataract surgery.

Combining all these technologies provides multiple benefits to the patient. It translates to safer and more precise surgery, early visual recovery and less chances of dependence on glasses.

However, in a certain number of patients undergoing cataract surgery, the back part of the lens capsule may thicken over a period of time causing blurred vision. This is known as Posterior Capsular Opacification (PCO), secondary cataract or “After Cataract”. This is not a complication. The condition is treated with a "YAG Laser Capsulotomy" with full restoration of vision

There are numerous benefits of cataract surgery, many of which cannot be measured statistically. These include: -

• Improved colour vision – colours are brighter and more vivid
• Greater clarity of vision – vision is crisper and sharper
• Improved quality of life – studies have repeatedly shown that people enjoy an improved quality of life after successful cataract surgery. Many people can resume driving, reading, writing,   watching television, sewing, household work and using a computer immediately after.

Even when retinal diseases or other problems prevent a total restoration of vision, the remaining vision is usually improved by cataract surgery.