Cataract

My mother has been diagnosed as having a cataract, and the doctor has recommended surgery to remove the cataract and insert a lens. The options are to have a rigid lens, or foldable lens, the cost of which is double that of a rigid lens. The doctor also suggested that the foldable lens requires less post operative care and also better vision. What is recommended? How long does the patient take to recover after cataract surgery?

 

Routine cataract surgery requires an incision of 11-12 mm in size. Phacoemulsification surgery for cataract is performed through a small incision. Small incisions such as those used in 'phaco' heal very quickly so that spectacles can be prescribed 4 weeks or earlier after surgery. No stitch or one stitch may be used in 'phaco' surgery whereas in 'non-phaco' intraocular lens surgery, 6-8 stitches are used. They cause changing curvature of the eyeball, and hence a delay in the final spectacle prescription to 6-8 weeks after the surgery. Another advantage of a small incision is that it is less likely than the other incision to cause a focussing problem known as astigmatism. The postoperative rehabilitation is faster and the patient can return to his or her normal work and activities very soon.

Phacoemulsification with foldable lens implantation can be performed through a very small incision (3.5-4 mm). Phacoemulsification with non-foldable (rigid) lens requires an incision that is only slightly larger than that for a foldable lens. The benefits are that it retains the advantages of phacoemulsification, while cutting down the cost of the lens. Your surgeon will be the best judge to decide whether your mother can undergo 'phaco' surgery. 'Phaco' surgery may not be recommended for patient with low endothelial cell counts (endothelial cells are the cells lining the inner surface of the cornea), patients with poorly dilating pupils, certain corneal diseases, and very hard cataracts. In such patients, conventional cataract extraction with rigid lens implantation still remains a safe, economical and effective method of treatment since the ultimate visual outcome in both conventional procedure and phacoemulsification with foldable/rigid lens implantation are comparable. The difference lies only in the rate of healing.