Article contributed by Dr. Vinay Nangia and Dr. Arshia Matin

Cataract or opacification of the natural crystalline lens is an age-related problem.

The goal today is to achieve early rehabilitation with excellent visual outcome in a cataract patient. To fulfill this is not at all difficult. The removal of the opacified or the cataractous lens can be done through the smallest of incisions, thanks to the gradual evolution and recent innovations in the design of Phaco machines.
The cataractous lens can be replaced with a foldable intraocular implant through an incision as small as 2.8mm.
 
Phacoemulsification:

This is the latest technique adopted to remove the cataractous lens. It utilizes ultrasonic energy for liquefying the cataract, so that it can be aspirated out through small tubing.
The removal of the cataract by Phacoemulsification has several advantages over conventional cataract surgery. These include:

• Small incision (2.8mm) required for surgery.
• Minimal surgical trauma to the eye so eye is not red and inflamed.
• The procedure is faster.
• Recovery is quick.
• No hospitalization is required.
• As no stitches are given so stitch removal is not required.
• Patient requires no bandage and post-operative management is minimal.
• Glasses may not be required.
• As incision is very small (2.8mm) and self sealing the risk of infection is minimal.
• The patient can travel immediately following surgery.
• The procedure is aesthetically better; the pupil remains round.
• He retains better vision as compared to conventional procedures.
• Eventually, as a result of the above contributing factors, the patient does not loose his productivity making Phacoemulsification a cost-effective and cost-saving technique for cataract removal.

The Foldable Intraocular Lens:

The foldable intraocular lens is literally folded to half its size. This makes it possible to insert the lens into the eye through the small Phaco incision, which may be as small as 2.8mm. Once a foldable lens has been placed in the capsular bag, it unfolds to its full normal size.
 
The numerous advantages of foldable IOLs over rigid IOLs are:

• The lens can be put into the eye through the small 2.8mm Phaco incision thereby retaining all the advantages of Phacoemulsification.
• The introduction of the lens is less traumatic.
• Placement of this lens is easier and more accurate in sharp contrast to rigid lenses.
• No risk of tilting of the foldable lens, & centration is excellent.
• All these factors enhance proper focusing of the rays improving the quality of vision and contrast sensitivity.
• Often in eyes following cataract surgery, a membrane forms behind the lens. This membrane being in the path of light hinders vision. It is removed by means of laser. The chances of formation of this membrane are more with rigid lenses and minimal with foldable lenses.
• Less possibility of glare with foldable lenses as they have superior surface qualities.
• These lenses are more biocompatible. This means they do not degrade inside the eye and do not react with ocular tissues to incite inflammation or reaction.
• The recently introduced blue-blocker lenses are able to filter off ultra-violet radiation just like the natural crystalline lens. This protects the eye from harmful UV radiation.

Conclusion:

Phacoemulsification alone does not solve the aim of sutureless cataract surgery unless it is combined with a foldable IOL. Thus the exact treatment for cataract is the ‘Phaco Foldable’ procedure. It is the preferred way at Suraj Eye Institute.