Treatment for cataract
Cataract is a progressive disease and treatment is essentially removal of lens followed by IOL or spectacles. Till date nowhere in the world an anti-cataract drug is approved for cataract. However, agents with unproven efficacy are available in some developing countries. Such agents might come up in the future, which help in delaying the onset and progression of cataract formation in humans.1
What is the Optimum Time to do Surgery?
Generally, the surgery is not required as soon as cataract is developed at same time, surgery should not be delayed till very late stage, as the chances of complication is more in that situation. Subjective feeling of the patient is also important. Generally the surgery is done when the patient feel difficulty in performing his day-to-day work like driving, work and his/her favorite hobby etc. Surgery is advised when there is any noticeable deterioration in eyesight.
The choice of surgery in the urban settings today is phacoemulsification with foldable lenses.2 Earlier, it was extra capsular extraction of lens and now it is used in selected situations.
Cataract surgeries
Phacoemulsification or Phaco
A small incision is made on the side of the cornea, (limbus) in the manner of Z and a tiny probe is inserted into the eye. This emits ultrasound waves that soften and break the lens so that it can be removed by suction. Then, foldable lens is placed in that position and the flap is replaced without any suture. It is also called ‘small incision cataract surgery’. Today most of the cataract surgeries are done by this method.8
Extracapsular Surgery
Here a long incision is made on the side of the cornea, and the lens is removed as one piece. The remaining parts are removed by suction. Once cloudy lens is removed, often it is replaced by an artificial lens called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of the eye. Some may not have an IOL because of the other eye disease or some problems during surgery. For these patients, a soft contact lens or glasses that provide high magnification may be suggested.8
Preoperative Medications for Cataract
- Prophylactic antibiotic capsules/tablets.
- Prophylactic antibiotic eye drops.
- Tab. Anxit 0.25 mg, a night before surgery.
- Topical mydriatic eye drops for the dilatation of the pupil.
After the Surgery of Cataract
Most of the patients notice an instant improvement in sight, although complete healing may take several months. Antibiotic and steroid combination eye drops are to be used for up to two months after surgery.
Most of them go home on the same day of the surgery, and will probably be able to carry on with normal daily activities, but do think about the following:
- Avoid rubbing the eye; better to wear an eye shield if the person is a restless sleeper.
- Do not lift any heavy things, and avoid strenuous exercise and swimming.
- If it is windy, take care of your eyes.
- Take care of washing the hair; avoid getting soapy water in the eye.
- Avoid wearing eye make-up until complete recovery.
Possible problems of cataract
Operative procedure for cataract is one of the most successful operations. An unforeseen serious complication occurs in less than 2% of patients. Thickening of the lens casing the part of the eye that holds the lens in place is among the most common and easily correctable complications. This is treated by laser treatment.3
Written by: healthplus24 team
Date last modified: April 27, 2012