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Cataract And Refractive Surgery: What Is The Difference?

Written and reviewed by
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Ophthalmology, DNB Ophtalmology
Ophthalmologist, Navi Mumbai  •  18 years experience
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Good morning friends.

I’m Dr. Harshavardhan Ghorpade from Fortis hospital Vashi, department of visual sciences. And Saroj Speciality Eye Clinic Vashi. I have done my MS. FRCS and I m a cataract, cornea and a refractive eye surgeon. You can contact me and know more about me through lybrate.com.

Today I’m going to talk to you about one very important topic which is of interest to one and all i.e. cataract and refractive surgeries, the recent advances in these surgeries. Let me first start by telling you what is cataract surgery? In cataract surgery the procedure is to remove the opaque lens of the eye which is called a cataract and replaced it by a nice clean artificial lens so that a patient can see again. While refractive surgery is something where we do refractive correction i.e. correction of power of the glasses either by the laser or by a surgical procedure. Both the things can be combined to ultimately give clear vision to the patient. So let’s start by starting with the recent advances in the cataract surgery. Well today cataract surgery has been sophisticated by doing procedures using ultrasound phaco probe which is about 2.2mm in size and it can be lesser of up to 1.8mm as well. We can do microincision cataract surgery through these probes. As a result of which we don’t require any anesthesia, any stitch and any blood coming out during surgery. During surgery we enter the eye with a very small opening and with the help of this ultrasound probe the emulsify or break the cataract into small pieces and then it is absorbed into the system of the machine, this is then replaced by a very small foldable lens. The lenses are of various types. They are usually monofocal, multifocal, or cylindrical. When we use monofocal lens we try to give you correction for distance so that most of the vision is good without glasses. When we use multifocal lens which is necessary to be put in both the eyes we can give you distance as well as near vision and when we use a toric lens we try to correct your cylindrical power as well. So ultimately by doing cataract surgery we not only remove the cataract but we also correct the glasses power of the patient so the patient can see very well without being too much dependent on the glasses. Apart from the various types of lenses we have now different types of machines which do the surgery. As I said micro-incision surgery is possible by using phaco probe but nowadays we are using laser as well to do the surgeries. Laser was a common term used in public to know or to talk about phacosurgery but today actual laser can also be used to do the surgeries. Although it is very expensive as well as time consuming. So ultimately if we have a good surgeon or experience surgeon micro incision phaco surgery is the surgery of choice even today and with the various type of lenses that available we can get rid of glasses as well apart from removing cataract. Now coming to the refractive surgery. Refractive surgery means removal of power of glasses doing a procedure on the eyes, this is usually done on the surface of the eye using a laser. What we do over here is laser surface ablation of the cornea which can lead to removal of glasses without doing any type of incision any cut or any kind of trauma to the patient or lots of tissue. So this a bladeless procedure and the patient is absolutely comfortable during the procedure and he may have some discomfort in first three or four days but overall at the end of the week he is absolutely normal as he was before without his glasses. This is one of the recent advances of bladeless procedures in laser surgeries. The other advances that we are doing nowadays is in very high refractive power say a power of more than seventeen and eighteen we introduces a special lens which is called as ICL which is put inside the eye without removing the cataract. This lens is like a contact lenses that sits on the lens i.e. given to us by nature. As a result of which the power which is there say e.g. patient with minus eighteen end up with the power which is close to zero and he would be again not dependent on his thick glasses. So this is another advanced that is occurred so that we can correct even the higher refractive errors. So overall if you look at the cataract and the refractive surgeries today we are doing very good sort of very advanced sort of treatments to all our patients which start with the removal of cataract, putting a lens of different types, we can do laser procedure over it to get rid of glasses. We can also put intraocular contact lenses, called ICL, which helps in removal of numbers with high powers and so at the end of the day our patients seems very happy and satisfy with all these results that are coming with modern advancements in cataract and refractive surgeries.

I hope you have understood the topic and if you have any more queries you can get back to me on lybrate.com.

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