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for more information, kindly visit http://www.Cataract.com.ph

  1. Is cataract surgery effective?

  2. How is a cataract removed?

  3. What happens before surgery?

  4. What happens during surgery?

  5. What happens after surgery?

  6. When will my vision be normal again?

  7. What is an after-cataract?

  8. How do I get more information?

 


 

 

Cataract removal is one of the most common operations performed in the U.S. today. It is also one of the safest and most effective. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

 

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There are two primary ways to remove a cataract. Your doctor can explain the differences and help determine which is best for you:

 

Phacoemulsification, or phaco. Phacoemulsification is an advanced technique of cataract extraction. It is also known as small-incision cataract surgery. Others call it the "no-needle, no-stitch" technique. After application of a local anesthetic, your doctor makes a small incision on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. The doctor then inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the cloudy center of the lens so it can be removed by suction. Most cataract surgery today is done by phaco.

Extracapsular surgery. Your doctor makes a slightly longer incision on the side of the cornea and removes the hard center of the lens. The remainder of the lens is then removed by suction.

 

 

 

 

 

 

Illustrated guide to Phacoemulsification

 

After placing topical anesthesia,  clear corneal incision is made with a crystal/diamond keratome. This is usually only 3.0 mm in size. This is a self-sealing incision which allows a sutureless procedure.

 

Image by Mark Erickson

Property of JirehDesign.com

 

Arguably one of the more delicate steps in the procedure of cataract removal, continuous curvilinear capsulorhexis (CCC) is the careful creation of a well-controlled tear in the anterior capsule of the cataract. 

 

Image by Mark Erickson

Property of JirehDesign.com

 

Ultrasonic vibrations (phacoemulsification) are now created to crush the cataract into manageable particles which are then aspirated into a port using the same tip (handpiece).

 

Image by Mark Erickson

Property of JirehDesign.com

 

The conventional way of approaching the removal of a cataract is by the "divide and conquer" method. The cataract is rotated and grooving is continued to create manageable pie shaped segments.

 

Image by Mark Erickson

Property of JirehDesign.com

 

This provides a side view of the actual inclination of the phaco tip (handpiece) as it proceeds with phacoemulsification of the cataract.

 

Image by Mark Erickson

Property of JirehDesign.com

 

After removal of the tough nuclear component, the softer cortical material are then aspirated with an irrigation/aspiration (I/A) handpiece. Complete removal of the cataract lessens the likelihood of developing an "after cataract" or posterior capsular opacification necessitating a YAG laser capsulotomy post operatively.

 

Image by Mark Erickson

Property of JirehDesign.com

 

After injection of viscoelastic material into the capsular bag and the anterior chamber a foldable intraocular lens is then inserted and unfolded into the eye.

 

Image by Mark Erickson

Property of JirehDesign.com

 

The intraocular lens is then dialed into place. The remaining viscoelastic material is removed. The eye is then checked for leaks.

 

Image by Mark Erickson

Property of JirehDesign.com

 

This is the lateral view of the posterior chamber intraocular lens after cataract surgery. 

 

Image by Mark Erickson

Property of JirehDesign.com

 

 

In most cataract surgeries, the removed lens is replaced by an intraocular lens (IOL). An IOL is a clear, artificial lens that requires no care and becomes a permanent part of your eye. With an IOL, you'll have improved vision because light will be able to pass through it to the retina. Also, you won't feel or see the new lens. The self-sealing corneal incision precludes the need for stitches, however, one may receive one or several stitches in some instances.

 

Some people cannot have an IOL. They may have problems during surgery, or maybe they have another eye disease. For these people, a soft contact lens may be suggested. For others, glasses that provide powerful magnification may be better.

 

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A week or two before surgery, your eye care professional will do some tests. These may include tests to measure the curve of the cornea and the size and shape of the eye. For patients who will receive an IOL, this information helps your doctor choose the right type of IOL. Also, doctors may ask you not to eat or drink anything after midnight the morning of your surgery.

 

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When you enter the hospital or clinic, you will be given eye drops to dilate the pupil. The area around your eye will be washed and cleansed.

The operation usually lasts less than 1 hour and is almost painless. Many people choose to stay awake during surgery, while others may need to be put to sleep for a short time. If you are awake, you will have an anesthetic to numb the nerves in and around your eye.

 

After the operation, a patch will be placed over your eye and you will rest for a while. You will be watched by your medical team to see if there are any problems, such as bleeding. Most people who have cataract surgery can go home the same day. Since you will not be able to drive, make sure you make arrangements for a ride.

 

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It's normal to feel itching and mild discomfort for a while after cataract surgery. Some fluid discharge is also common, and your eye may be sensitive to light and touch. If you have discomfort, your eye care professional may suggest a pain reliever every 4-6 hours. After 1-2 days, even moderate discomfort should disappear. In most cases, healing will take about 6 weeks.

 

After surgery, your doctor will schedule exams to check on your progress. For a few days after surgery, you may take eyedrops or pills to help healing and control the pressure inside your eye. Ask your doctor how to use your medications, when to take them, and what effects they can have. You will also need to wear an eye shield or eyeglasses to help protect the eye. Avoid rubbing or pressing on your eye.

 

Problems after surgery are rare, but they can occur. These can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, or light flashes. With prompt medical attention, these problems usually can be treated successfully.

 

When you are home, try not to bend or lift heavy objects. Bending increases pressure in the eye. You can walk, climb stairs, and do light household chores.

 

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You can quickly return to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.

 

If you just received an IOL, you may notice that colors are very bright or have a blue tinge. Also, if you've been in bright sunlight, everything may be reddish for a few hours. If you see these color tinges, it is because your lens is clear and no longer cloudy. Within a few months after receiving an IOL, these colors should go away. And when you have healed, you will probably need new glasses.

 

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Sometimes a part of the natural lens that is not removed during cataract surgery becomes cloudy and may blur your vision. This is called an after-cataract. An after-cataract can develop months or years later.

Unlike a cataract, an after-cataract is treated with a laser. In a technique called YAG laser capsulotomy, your doctor uses a laser beam to make a tiny hole in the lens to let light pass through. This is a painless outpatient procedure.

 

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How do I get more information?

 

There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
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WEBSITES.

     http://www.EyeRepublic.com.ph - EYE REPUBLIC Ophthalmology Clinic
     http://www.OCP.com.ph - Ophthalmic Consultants Philippines Co. -
     http://www.LASIK.com.ph - Refractive Surgery Resource
     http://www.Cataract.com.ph  - Cataract Surgery Resource
     http://www.Eye.com.ph - Eye Information Online
     http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
     http://www.Retina.com.ph - Retina Surgery Resource
     http://www.Glaucoma.com.ph - Glaucoma Online
     http://www.Uveitis.com.ph - Uveitis Online

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     Cataract Service - cataract@EyeRepublic.com.ph
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EYE REPUBLIC Ophthalmology Clinic

Manila

3/F Don Santiago Building Units 309-310

1344 Taft Avenue, Ermita

Manila, 1000 Philippines

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EYE REPUBLIC Ophthalmology Clinic

Asian Hospital and Medical Center

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2205 Civic Drive, Filinvest, Alabang

Muntinlupa City, 1781 Philippines

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EYE REPUBLIC Ophthalmology Clinic

Medical City

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MERALCO Compound, Ortigas Avenue

Pasig City, 1604, Philippines

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EYE REPUBLIC Ophthalmology Clinic

St. Luke's Medical Center

6/F Cathedral Heights Building Complex (CHBC)

North Tower Suite 614

279 E. Rodriguez Sr. Boulevard

Quezon City, 1102 Philippines

Direct and Fax: (632) 407-3883

Mobile: (63917) 855-2020

Map and directions

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All clinics are closed on Sundays and Holidays

 

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 CATARACT SURGERY information compiled by Dr. Manolette R. Roque and initially uploaded on May 1, 2005.

Last updated on September 13, 2007.

Note: Some of the materials here are abridged from the National Eye Institute, National Institutes of Health website.

 

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