Cataract develops while ageing wherein the lens of your eye which refracts (bends) light rays for vision. It is a condition where the lens becomes cloudy or foggy giving a yellow, blurred or dim vision and is painless. You can also have poor night vision and reading and driving might be difficult for you. The surgery is a common and safe procedure that deals with removal of this cloudy lens and replacing it with an artificial one, called an intraocular lens (IOL) for an improved vision. The three types of IOL available are fixed strength (monofocal) or toric lenses used in majority of cataract surgery usually set for distance vision; accommodating lenses focus on both distant and near objects like natural lens does and multifocal lenses also for near and distant vision. The procedure takes about 30-45 mins and is usually carried out under local anaesthesia. The accommodating and multifocal lenses come with an advantage of reducing the need to use reading glasses post-surgery. But despite the type of lenses, most people do require reading glasses after surgery. Cataract treatment assisted with laser surgery is used for making extremely accurate incisions in very less time. So, improved accuracy is characteristic of laser assisted surgery, giving a high correction degree for refractive error like astigmatism or myopia or hyperopia.
In Laser-assisted surgery a camera or ultrasound imaging device is positioned over the affected eye to plot the surface of the lens and get its information for the corneal incision with a sophisticated 3-D eye imaging known as OCT (Optical Coherence Tomography). The device then procures precise size, depth and location of the incisions from a computer that programs the laser irrespective of the surgeon’s experience and expertise. This type of incision comes with the advantage of self-sealing after the operation reducing the possibility of infection. A femtosecond laser is used for anterior capsulotomy for precision and reproducibility. The laser softens the cataract, makes the corneal incision, then opens into the lens capsule, the ultrasound probe breaks the lens thereby sucking it out in pieces and finally IOL implant is carried out. Studies have shown that opening with the help of this technology is about 10 times more accurate than done with hand held devices. With the help of laser technology, less energy is required for the process of lens and cataract fragmentation and therefore reduced chance of twisting and burning the incision. Just before the surgery, the pupil is dilated (widened) with the help of an eye drop and is numbed with a local anaesthetic. So, the femtosecond laser technology brings new levels of accuracy, predictability and safety.
Every person with cataract does not need surgery. People with cataract also get double visions, have problem to read and work on computer, have poor night vision, find it difficult to drive in the dark. Also those who fail in the driver’s vision test, or ones who are more sensitive to the sun’s glare, and for whom playing sports like golf are difficult, are eligible for laser cataract surgery. Added to this, if you also suffer from astigmatism and wish for a refractive error correction during cataract surgery, laser assisted surgery can be preferred.
People with minor cataract can be fine with their sight if they use a magnifying lens or wear a prescript reading glass or even bright light. Also, if you have irregularly shaped or too thin corneas, dry eyes, existing unstable vision, physiological factors such as pregnancy, heightened refractive error and existing degenerative disorders.
Side-effects due to laser cataract surgery are rare to happen, although some of them that have been reported are dry eyes. About 50 percent of laser eye surgery patients come across eye syndrome which can be corrected with the aid of eye drops. Patients also complain of minor discomfort and visual disturbances with mild irritation, halos, glares and hazy vision that are mostly temporary. Eye infection can also occur in few patients, in some cases, they can also require wearing glasses or contacts, and some may complain about flap complications. There can be temporary, mild subconjunctival haemorrhage in some operated ones.
You will be prescribed with eye drops to avoid infection. Putting any pressure on your eyes, picking up heavy objects, driving or bending over to anything must be avoided. Your doctor will suggest you to put on an eye-shield for the first few days while sleeping. It takes about 8 weeks for your eyes to heal completely and around 90 percent of people have improved eyesight after the surgery. Glasses or contact may still be required to be worn even after the surgery. Clear vision after few hours of surgery may be seen in few patients and each one heals in one’s own pace and may require a week or even two to view sharpest images.
The surgery recovers within about a month with the eye completely healed up.
The cost of laser cataract surgery may be as high as Rs.85,000 which can go somewhere upto Rs. 1.2 lakh depending upon the place in India and the hospital too.
Yes, the results of laser cataract surgery are mostly permanent and may last a lifetime although the person is required to wear glasses post-surgery for protection and sharp vision.
The alternative to laser cataract surgery can be the traditional surgery requiring tools to carry out corneal incision and placing of artificial lens manually. Also, surgery with phacoemulsification is a modern technique of surgery wherein the internal lens of the eye is emulsified with ultrasonic handpiece and extracted from the eye. The extracted fluids are then replaced with a balanced solution for maintaining the anterior chamber of the eye.