Modern cataract surgery - Bursting Myths
Updated: Jun 21, 2022
In my last 18 years of practice as a general ophthalmologist and cataract surgeon . I have seen massive advances in surgical technique , technology , intra ocular lens options and technology . However some notions rather myths about cataract have remained stuck among general public .
This write up is to bust those myths and educate everyone with the facts .
Myth no 1
Cataract is something new that grows into the eyes
Cataract is not an extra growth , but the clouding of the natural biological lens inside the eye and it is as physiological as any other aging process , like wrinkling skin or greying of hair
Cataract needs to be removed after it is 'ripe'
In olden days we would wait for the cataract to 'mature' . Meaning , the lens to become more and more clouded and wait for the person to become completely blind.
Those days we would make a large opening in the eye and remove the cataract in to .
Today, it is fragmented within the eye using ultrasound energy and removed by vaccum . This technique is popularly called "Phaco" . Softer cataracts get fragmented and sucked out like butter , whereas harder cataracts need to be grooved and cut like rock . Hence , mid stage cataract is the best time to get operated . And at mid stage one might still have manageable vision .
Don't see sunlight or watch TV or go out after cataract surgery.
Modern cataract surgery , is a day care technique aimed at minimum down time and early revertal to all day to day activities. The intra ocular lenses mostly have UV protective property.
We encourage patients to go to walks , watch TV and stay active . This is
especially important to keep diabetes under control in post op period which is important for quick healing of operated sight .
Myth 4 :
Don't eat hard food like meat or chapati after cataract surgery.
The inserted intraocular lens is usually placed inside the bag and secure right from immediate post operative time. It is completely alright to eat your normal food after cataract surgery
Myth 5 :
Diabetics should not undergo cataract surgery as they carry highest risk of eye infection.
Diabetics like anyone else develop cataract in the eyes , in fact at a younger age. Diabetic cataract surgery involves some extra precautions like keeping the blood sugars optimum in the perioperative period and also we surgeons factor in the condition of retina . The choice of intraocular lenses is also made differently for diabetics.
Hence with special precautions diabetics are entitled to and must undergo cataract surgery.
Myth 6 :
After cataract surgery one does not have to wear spectacles.
For most of the cataract surgeries we calculate the intraocular power and implant a lens which caters to distance vision. For near vision one would still have to wear spectacles.
However there are also options like multi focal lenses and toric lenses available. which are highly customized intraocular lenses, which almost eliminate the necessity for wearing any glasses after the cataract surgery. However an absolute guarantee can never be given since some remainder power might show up after the eye tissue has healed .
Myth 7 :
There must be long gap given between two eyes to get operated.
Since cataract surgery is a day care surgery done under local or topical anaesthesia and it's preferred that when both eyes have cataract ,surgery is completed back to back with a gap as small as one day to one week. This would also help the brain to adapt to the new lens in the eye and established binocularity.
Myth 8 :
After cataract is removed , getting an intra ocular lens put inside the eye is an option
Once the cataract is removed an intraocular lens has to be compulsorily implanted within the eye both to act as a refractive interface and also to keep the anatomy of the eye intact. For some reason if and the lens cannot be implanted in its original place there are alternative sights in the eye where lens is still implanted.
Myth 9 :
Once cataract is removed it can still come back.
Cataract surgery is a one time surgery and once the cataract is removed and intraocular lens fixed cataract will not develop again. However in a small percentage of people the back surface of the bag where the artificial lens has been planted can become a opaque and this is called as "after cataract"or "posterior capsular opacity" which can be easily polished by laser.
Myth 10 :
Once the eye has undergone cataract surgery one need not visit the ophthalmologist
During cataract surgery the cataractous lens is removed and an intraocular lens is implanted. The eyeball and the rest of the eye structures remain same. Even after cataract surgery is done one has to regularly visit the eye doctor to keep monitoring for glaucoma, health of the retina and condition of the other structures within the eye.
Author: Dr. Jayashree K Bhat (MBBS, DNB - Ophthalmology, Founder & Senior Ophthalmologist)