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Eye Care – Surgery

Cataract Surgical Techniques

Several techniques are used for removing cataracts.

In Phacoemulsification, a tiny instrument is used to break the cataract into small pieces using ultrasound vibrations. These fragments are then removed through a small incision, and a new lens is inserted without the need for stitches. This minimally invasive procedure promotes faster healing and quicker return to normal activities.

Small Incision Cataract Surgery (SICS) is a newer technique where the cataract is manually removed through a small incision, leading to swift healing and rapid recovery.

Extracapsular Extraction involves removing the lens in one piece through a larger incision. An artificial lens replaces the removed one, and the incision is closed with stitches. This method is typically reserved for advanced cataracts and entails a longer recovery period. Your surgeon will determine the most suitable surgery method based on your individual needs.

Planning for Surgery

Surgery for cataracts doesn't need to wait until the cataract fully matures or vision becomes completely cloudy.

You and your ophthalmologist will decide on the timing of surgery together. Inform your doctor about any medications or herbal remedies you’re taking. Our counsellors will guide you through pre-operative procedures and provide a cost estimate. Before surgery, routine medical and blood tests are required, and you should bring your glasses or contact lenses for prescription checks. An A-scan will determine the power of the new lens.

Wash your face before surgery and follow instructions for eye drops to dilate your eye. Fasting may be advised prior to surgery. Only one attendant is permitted, and children under 15 years old are not allowed unless they are patients.

Cataract surgery has a high success rate, but complications can occur. The surgery takes about 30 minutes under local or general anaesthesia, with sterile draping and oxygen provided. You’ll be awake but won’t feel pain due to numbed nerves. Bleeding during surgery is minimal.

Care after Surgery

After surgery a bandage or shield will be placed over your eye.

After surgery, rest until you’re ready to leave. During the day, wear protective glasses or an eye shield, and wear an eye patch at night to prevent accidental injury. Your doctor will advise when you can stop using these. Avoid getting the operated eye wet for 15 days, but you can bathe carefully below your neck. You may gently clean the eyelids using boiled cotton or a sterilized tissue.

Some important Tips

Do not rub the operated eye.Do not use any eye cosmetics until the doctor allows it.
Do not wash your hair until the doctor says you can.Shave carefully, soap or water should not enter the eye.
Avoid any vigorous activity.Do not lift heavy things
Do not bend so that your head is lower than your waist.Avoid driving till your vision improves.
Avoid sleeping on the operated side.No sexual intercourse until permitted by the doctor.
Avoid alcoholic beverages.Watch television for short periods only.

Please follow the advice of the patient counsellor about medication and follow-up visits.

Be alert for Problems
If you have any of these symptoms that last more than 24 hours, inform the Institute or an ophthalmologist immediately:

Any sudden change in vision or blurring of visionIncrease in sensitivity to light or seeing flashes of pain
Increase in rednessSwelling of the eyelid or bleeding
Nausea or vomitingWhite or cloudy cornea or pupil
Persistent discomfort or pain – if the pain is severe, do not delay, contact us immediately.
Surgery of the Interior of the Eyeball with vitrectomy

Vitrectomy is a delicate surgical procedure that involves the use of an operating microscope and specialized needle-sized instruments.

Indications and Procedure: The primary indication for vitrectomy is the removal of non-transparent vitreous obstructing incoming light. This involves removing most of the cloudy vitreous and replacing it with a clear solution. Vitrectomy can also address retinal detachment, blood clots, infections, cataracts, foreign bodies, and abnormal membranes within the eye. Occasionally, air, gas, or silicone oil may be injected post-surgery. The surgery, performed under general or local anesthesia, takes two to four hours. One operation is usually sufficient, though additional surgery might be needed. Hospital stays typically last one to two days, with face-down sleeping recommended for a few days post-surgery.

Post-Operative Care: Patients should rest at home for two weeks, avoid traveling except for doctor visits, and strictly follow postoperative instructions. Air travel should be avoided if gas has been injected into the eye. Most patients resume routine activities in four weeks.

Success Rates: Vision improves in 90% of simple cases and 60% of difficult cases. Full clarity of vision may take up to three months to determine. While patients usually regain the ability to see large objects, fine and reading vision may not fully recover.

Side Effects and Complications: Temporary side effects include blurred vision, eye pain, redness, swelling, mucus discharge, enlarged pupils, and double vision, typically resolving within weeks. Complications, though rare, can include recurrent bleeding, infection, elevated eye pressure, retinal detachment, or cataract, which may require further surgery. Very rarely, complications can lead to complete vision loss. An anaesthetist should be consulted for aesthesia-related risks.

Instructions for Patients who have had Surgery of the Retina or Vitreous

The following precautions should be observed for three weeks:

Do not lift anything that weighs more than five kilograms.Do not bend over so that your head is below your waist.
Avoid sleeping on the operated side, unless you are instructed to do soAvoid sexual intercourse.
Avoid alcoholic beverages.Do not rub the operated eye.
You may watch television sparingly.You may gently rub the eyelids with cotton or a clean tissue moistened with warm water. Do not bathe the eyeball. Eye bandage
You may remove the eye patch on your doctor’s advice (usually after one day).Always wear either protective glasses or an ‘eye shield’ to avoid accidental injury. Medication
You may bathe carefully from below your neck and shave, but do not get the eyeball wet for at least two weeks. You may carefully clean the forehead and cheek with a wet cloth.Always wear either protective glasses or an ‘eye shield’ to avoid accidental injury. Medication
Avoid vigorous activity.No automobile trips except to visit the doctor.

Follow the instructions that are given to you when you leave the hospital.


Follow-up appointment

Please adhere to the follow-up appointment date given to you at the time of discharge. In case of doubt, contact us. Some discharge from the eye is to be expected. This should normally show gradual improvement, but increasing discharge or pain or decreasing vision should be reported to the doctor immediately. You may call us for any other concerns that you have.
Instructions for Patients who have had Surgery of the Retina or Vitreous Special Face-Down orders

  1. Certain retinal detachments require the placement of a bubble of sterile gas in the interior of the eyeball. When you observe a face-down position this gas rises toward the ceiling and pushes the retina back into place. The gas will be absorbed by the eye within a few weeks.
  2. You will be asked to lie on your side while in the recovery room.
  3. After moving to your ward bed, you will be placed in position (A) or (B). (A) Place a pillow under the chest and a rolled-up towel (or small blanket) under the forehead. (B) Lie on your side with your face turned toward the mattress. NOTE: The long axis of the head should always be parallel to the floor.
  4. You may lie on your back for 3 – 4 minutes for changing of the eye bandage, putting eye drops or for the doctor’s examination.
  5. For the first 10 days after surgery, you have a choice of five positions: (A) Prone (as illustrated) (B) On side (as illustrated) (C) Sitting with elbows on knees. (D) Sitting with forehead on table edge, with small pillow (as illustrated). (E) Walking in the house with the long axis of head parallel to the floor.
  6. Eat facing down, drink beverages with a straw.