Intraocular Lens tear.

Improved Dependability With The New Toric IOLs

Today’s patients accept nothing less than perfection

Surgeons have two methods for correcting pre-existing corneal astigmatism during cataract surgery: 

We can perform arcuate incisions (typically LRIs)  or  can implant a toric IOL. 

There are numerous toric IOLs available to us from Acri.Tec, Alcon, Abbott Medical Optics (AMO),  some are also available in a toric multifocal platform. From among the many options, one should look for toric IOLs that offer good optical performance, excellent visual quality, with good alignment and excellent rotational stability. Ease of use for the surgeon is also a factor. 

Pearls for success

Excellent visual outcomes with a toric lens is dependent on two things: Precise axis placement initially, followed by rotational stability postoperatively.

Today’s toric IOLs offer much greater stability than earlier versions, increasing patient satisfaction and helping us set the bar for outcomes higher. I believe we should be able to get at least 80 per cent of our patients within 0.5 D of the intended cylinder correction.

With reference inputs from Improved Stability In Toric IOLs  Sunil Shah Posted in:  2011  Sept /Cataract and Refractive

Congenital Cataract

Natures Anomaly
Congenital Cataract.
The cataract is present since Birth and till the current condition is not causing any Visual Disturbance.
No surgery is required for the same

CATARACT

Giving Back To The Society

Giving Back To The Society

Our Team operated more than 60 patients for a variety of diseases completely Free of cost. It was amazing to find one person with Bilateral mature cataract, means he could not see, and was using white stick and living life since more than 2 years. Cataract is the most easily treatable Blindness.
Many patients were also treated on and Outpatient basis.

All the surgeries were performed under Strict Hygienic notified conditions and the patients were also given post operative medicines to complete the Treatment.

A sense of Peace and solace felt and achieved and share with all the Good Blessings recieved from them.

I thank the ALMIGHTY, that he has chosen me and given me the Atoned skills to spread the Good in the society.

Dr. Jigar Bathia Operating

Lens extraction should be considered for Open Angle Glaucoma

By Ron Rajecki

Lens extraction for primary angle-closure glaucoma (PACG) results in good long-term control of intraocular pressure (IOP), and should be considered among the armamentarium of approaches to treat PACG — especially for patients who have hyperopia, or a thick and anteriorly vaulted lens, according to a report in Current Opinion in Ophthalmology.

The authors of the report note that anatomical opening of the angle, IOP reduction, and improved vision are all benefits cited by proponents of lens extraction in PACG.

The evidence base for ophthalmic surgeons to consider lens extraction in the management of PACG has grown stronger recently thanks to randomized controlled trials, case-control studies and cohort studies. Such studies have also added to the discussion of whether trabeculectomy or goniosynechialysis should be combined with lens extraction.

New insights have also been gained thanks to imaging modalities, such as anterior segment optical coherence tomography, that are providing information on the mechanical features of the lens in angle closure.

Steroid Induced Cataract

Inadvertent use of steroids in the eyes can cause Cataract. Unfortunately this patient has to use it for the treatment of asthma. As always medicines can be boon to over part of the body and Bane to another.

Always the pros are more than the cons and hence survival is better.

A classical Posterior Sub Capsular Cataract

Cataracts From Statins ????

CATARACT

Cataracts From Statins? More Signals Emerge in Analyses

Statins are a class of medicines that are frequently used to lower blood cholesterol levels. The drugs are able to block the action of a chemical in the liver that is necessary for making cholesterol. Although cholesterol is necessary for normal cell and body function, very high levels of it can lead to atherosclerosis, a condition where cholesterol-containing plaques build up in arteries and block blood flow. By reducing blood cholesterol levels, statins lower the risk of chest pain (angina), heart attack, and stroke. 

By  Steve Stiles

VANCOUVER, BC — Statin therapy significantly elevates the risk of developing cataracts severe enough to warrant surgery, suggests analyses of two distinct cohorts, one from Canada and another from the US, that add to a hazy landscape of prior studies variously concluding for or against such a risk for the widely used drugs.

For now, the possibility of such a risk from statins and its potential mechanisms should be explored in prospective trials, “especially in light of increased statin use for primary prevention of cardiovascular disease and the importance of acceptable vision in old age, when cardiovascular disease is common,” according to the report, published in the December 2014 issue of the Canadian Journal of Cardiology with lead author Dr Stephanie J Wise (University of British Columbia, Vancouver).

“However, because the relative risk is low and because cataract surgery is effective and well tolerated, this association should be disclosed but not be considered a deterrent to use of statins when warranted for cardiovascular risk reduction,” they write.

Cataract

For most people with poor vision from cataract, the opportunities of regaining good vision and resuming normal daily activities are excellent.

What is a cataract?
The term ‘cataract’ is used to describe the clouding of the natural lens of the eye. The vision dims because the cataract prevents light from passing beyond the lens and focusing on the retina.

Common symptoms of a cataract:

1. Painless blurring of vision
2. Glare or light sensitivity
3. Frequent changes in eyeglass prescription
4. Poor night vision
5. Needing a brighter light to read
6. Double vision in one eye
7. Fading colours

Common misconceptions cleared:

1. Cataract is not a film over the surface of the eye
2. It is not caused by overusing the eyes
3. It is not infectious and will not spread from one eye to the other
4. It is not a cancer
5. It is not a cause of irreversible blindness

What causes a cataract?

1. The most common cause is due to aging and referred to as a ‘senile cataract’.
2. Other common causes are:
3. Family history
4. Medical problems, such as diabetes
5. Long-term use of medications, such as steroids
6. Injury to the eye
7. Congenital, since birth
8. Previous eye surgery
9. Long-term unprotected exposure to sunlight

How fast does a cataract develop?
Cataract development varies among individuals and may even vary between the two eyes. Most cataracts associated with the aging process develop over years. Cataracts in younger patients and in those with diabetes may develop more rapidly.

How do you treat a cataract?
Surgery is the only way a cataract can be treated. No dietary supplements, medications, exercises or optical devices have been proven to prevent or cure cataract.

When should surgery be done?
Surgery should be considered when the cataract causes visual disturbance enough to interfere with daily activities. Based on these needs and the examination findings, the patient and the ophthalmologist should decide together when surgery is appropriate. Cataracts need not be mature or ‘ripe’ before removal.

What should you expect from a cataract surgery?
Cataract surgery is a day care, microscopic surgery performed under anaesthesia eye drops or local anaesthesia. The cloudy lens is removed leaving its capsule behind, within which a permanent, artificial intraocular lens is implanted. Today, there are a wide range of intraocular lens implants available, which not only replace the cataract, but also give visual advantages with better near vision, improved night vision and also can reduce or eliminate the need for spectacles post surgery.
After cataract surgery, you can return immediately to almost all routine activities. Medication must be administered as per the instructions of your cataract surgeon or ophthalmologist.

Low stress cataract surgery at Bathia Hospital and Eye Clinic
Phacoemulsification is a micro-incision technique of cataract surgery wherein an ultrasound probe breaks the cataract into tiny pieces and sucks them out. The foldable lens implant is inserted through a very small incision (2.8 – 3.0 mm) as compared to an approximately 5 mm incision to accommodate a non-foldable lens. The incision are self-sealing and needs no stitches. Your ophthalmologist will help you decide as to which lens implant is most suitable for you.

Benefits to you:

1. Smaller incision resulting in faster healing and visual rehabilitation
2. Reduced surgical time
3. No stitch surgery.
4. Painless or minimal post-operative discomfort
5. A quick return to your normal routine.

Can a cataract be treated with medicines or a laser?
No. Since the cataract occurs within the lens matter of the eye, no medication stops the progress of or treats the cataract. There is no medical or laser treatment for cataract other than replacing this lens with a surgery.
However, in layman terms today’s modern cataract surgery is called ‘laser cataract surgery’ as there are no stitches, although there is no actual use of the laser. The cataract is dissolved using ultrasound waves from an equipment and is medically termed ‘phacoemulsification’.
 
Today’s procedures are quick, not taking more than 20 minutes of surgical time, pain free under topical (only eye drops) or local anesthesia. Ask your ophthalmologist if you are eligible for topical anesthesia.

Are there any complications of cataract surgery?
At our centre, we follow the highest standards of healthcare and strict protocols of infection control. 
We understand your fears regarding an eye surgery, but you stand a greater risk of not doing cataract surgery when required, as the longer you wait the more difficult it becomes to treat the cataract easily and there is a greater chance of surgical complications.

Standard Vs Premium Lens Implants?
Multifocal and Accomodative Implants are a new technology in cataract treatment wherein you can gain additional benefit of reducing your dependence on reading glasses.

Standard Lens Implants	Premium Lens Implants
Single focus- usually distant	Multiple focuses- near, intermediate and distant
100% need for reading glasses	Reduces or eliminates need for reading glasses
Insurance usually covers the cost	May be reimbursed partially by insurance

Lens Implants available at  Bathia Hospital and Eye Clinic:

Standard IOLs
Monofocal: AMO Sensar / Akreos / Rycef /Matrix
Monofocal Wavefront : AMO Tecnis / Akreos AO / Zeiss ZO/Acrysof Alcon IQ
Monofocal Microincision: Bausch and Lomb MIL
Monofocal Toric: Alcon / Zeiss

Premium IOLs
Multifocal: Tecnis / Restor / Rezoom/ Zeiss
Multifocal Toric: Alcon / Zeiss
Accomodative: Crystalens