Types of Cataract Surgery

ECCE,SICS,PHACO,MICS

ECCE – Incision Size 10 to 12mm

Requires Large Wound Space

Requires Stitches

Visual recovery takes longer time

Requires long term post operative follow-up

In SICS – small Incision Cataract Surgery, 6mm Incision is made in the eye for cataract removal

6mm Incision size is required mostly

Suitable for Rigid lens implant

Require Stitches Rarely

Visual recovery takes longer time

Requires long – term post operative follow-up

In Phacoemulsification Ultrasound technology is used to break and Emulsify the Cataract through a 2.8mm Incision for the procedure. This smaller incision heals faster

Smaller Incision is sufficient (2.8mm)

Suitable for Foldable lens implant

No stitches

Instant visual recover

Short term post operative follow-up

Micro Incision Cataract Surgery

This latest surgical technique involves only 1.4mm incision in the eye for cataract removal with the ultrasound phaco technology.

Very tiny wound is made (1.4mm)

IOL can be implanted through 1.8mm

No stitches

Walk in – Walk out, visual recovery is fastest

Short term post operative follow-up

Advanced technique

Minimally invasive

Better functional vision

Normal Vision Vision with Cataract

When is the best time to treat cataracts?

What happens if cataracts go untreated?

Can cataracts come back?

How successful is a cataract surger?

How do i know which lens implant is right for me?

What is presbyopia?

What is a multifocal lens?


Many people believe cataracts have to be ‘ripe’ before they can be removed. This is no longer true. Today, cataract surgery is a routine procedure that can be performed as soon as your vision interferes with the quality of your life.


Over time , the clouded areas of your lens can become larger and more dense, causing your sight to become worse. This could take anywhere from a few months to many years. Eventually, your entire lens can cloud over leading to blindness.


Once a cataract has been removed it cannot return. However , over time some patients may complain that their vision has once again become cloudy. This condition is known as secondary cataract. It can be easily and rapidly treated by a simple laser procedure performed in the office.


Cataract surgery has a overall success rate of 99% or greater. Continuous innovations in techniques and instruments have made the procedure safer than earlier.


No single lens works best for everyone and only your ophthalmologist can determine the most appropriate option for you.


Many people believe cataracts have to be ‘ripe’ before they can be removed. This is no longer true. Today, cataract surgery is a routine procedure that can be performed as soon as your vision interferes with the quality of your life.


Presbyopia is the condition in which the lens of the eye loses its ability to focus. It is a common condition that could accompany cataracts and impair your ability to see objects that are close up. Have you ever found yourself holding a menu or book farther away to read it? the need for reading glasses is usually a sign of presbyopia. This aging of the eyes eventually affects everyone. If you have cataracts with presbyopia, the lens can correct both conditions.


Multifocal lens is a breakthrough lens for cataract surgery that lets patient see from near to far, usually without glasses. It is effective when placed in both eyes. Most of the multifocal lens patients find that they can read a book, work on the computer, drive a car – day or night – and play golf or tennis with an increased freedom from glasses. You my experience visual disturbances in low lighting conditions, therefore increased care should be taken when driving at night

Cataract Natural Part

A NATURAL PART OF AGING

The natural lens, located behind the iris, works just like the lens of a camera focusing light images on the retina which sends images to the brain. With the onset of cataract, your natural lens becomes so clouded that it prevents light and images from reaching the retina. You now start seeing objects blurred. Bright colours seem dull. Seeing during low light conditions become more difficult, your glasses become in effective.

Healthy EYE EYE with Cataract

What causes Cataract?

What exactly is cataract surgery?


Normal aging process

Diabetics may cause

Injury

Prologed use of medication (eg : steroids)

The best way to treat cataract is with surgery which removes the old, clouded lens and replaces it with a new, artificial one to restore your vision. Successful cataract surgery can significantly improve your quality of life.


It is one of the safest and most successful procedure

Surgery is performed mostly under local anaesthesia rarely needs general anaesthesis

Modern surgery uses an ultrasound (phacoemulsification) to remove the cataract

Artificial lens is placed in to the eye

The surgery is performed without stitches

It takes 15-45 minutes

Safe and effective

The risk of complication is less than 1%

Lens Options

Near Vision Intemediate Vision Distance

Monofocal Lens

A lens with a single focal point, designed to replace cataracteous lens and provide distance vision, while offering enhanced image quality.

Aspheric

Lens For enhanced contrast & Better Night vision

Cataract + Astigmatism

Astigmatism correcting Monofocal Lens A lens with a single focal point, designated to replace Cataracteous lens and pre – existing astigmatism, providing distance vision, while offering enhanced image quality.

Multifocal IOL

Cataract & Astigmatism

What is Astigmatism?

How does TORIC IOL give better result in cataract surgery?

Sometimes the surface of the cornea is curved in such a way that vision becomes distorted or blurred. A person who has both cataracts and a corneal astigmatism will not regain high – quality distance vision after cataract surgery unless the astigmatism is also corrected.

The toric intraocular lens (IOL) replaces your eye’s natural clouded lens during cataract surger. It has the ability to reduce or eliminate corneal astigmatism at the same time it corrects cataracts. The result is typically improved distance vision and less dependence on spectacles . however , most patients still need corrective lenses for near and intermediate tasks. With the toric lens, your distance vision can be clear and vibrant, giving you the power to see your best and be your best.
Vision with Cataract traditional replacement Vision with Toric IOL

Retinal Detachment (RD)

WHAT IS RETINAL DETACHMENT?

When the retina is pulled on lifted from its normal position it results in a detachment. This causes permanent vision loss if not treated immediately. This is a medical emergency and should be treated immediately.

bullet-blueSudden or gradual increase in floaters

bullet-blueFlashes of light

bullet-blueAppearance of a curtain over the field of vision

bullet-blueWho is at risk of retinal detachment?

bullet-blueIt can occur at any age but people over 40 are at a higher risk.

bullet-blueMen are more prone to it than women.

bullet-bluePeople who are extremely near sighted.

bullet-bluePeople with a family history of retinal detachment.

bullet-bluePeople with other eye diseases or injuries.

Computer Vision Syndrome (CVS)

WHAT IS COMPUTER VISION SYNDROME?

A number of professionals using computers experience vision and eye related problems especially due to poorly designed work stations and prolonged usage. These vision related problems are grouped as Computer Vision syndrome in short “CVS”.

i 20x20What are its symptoms?

i 20x20Who is affected? How?

i 20x20What are the reasons?

i 20x20What does computer vision clinic do?

bullet_purpleEye strain

bullet_purpleBlurred vision

bullet_purpleDry and irritated tired eyes

bullet_purpleHeadaches

bullet_purpleNeck and backaches


Computer Vision Syndrome ( CVS ) affects 75% of the computer users, most markedly those who work more than 3 to 4 hours with computers. Computer users? productivity is affected.

bullet-blue Uncorrected refractive error

bullet-blueDecreased blink rate

bullet-blueGlare and reflection from the monitor

bullet-bluePoor Ergonomics


Evaluate at simulated computer environment ( Questionnaire + Executive Vision check + Orthoptics + Tear

bullet_purpleManagement

bullet_purpleGlass

bullet_purpleArtificial tears

bullet_purpleVision therapy

bullet_purpleRecommendations about ergonomics

WHAT IS CORNEAL GRAFTING?

When cornea is damaged beyond repair it is removed either fully or partly and replaced by a donated cornea.

i 20x20What is the cornea?

i 20x20Who will require corneal graft?

i 20x20Who can donate corneas?

i 20x20What should we do after the surgery?


Cornea is the clear outer layer covering the eye. It helps focus and transmit light as it passes through the lens on to retina.


People with congenital abnormalities that inhibits normal vision.People with clouded corneas through childhood diseases, trauma or infections.People with degenerative eye diseases that cause loss of vision.


Anyone with no infectious diseases.


Do not rub or touch the eye.Avoid smoky and dusty rooms, which can cause irritation. Wear sunglasses if the eye is light sensitive.Do not play contact sports and swimming in particular. Ask the doctor if you are unclear which sports you should avoid.You will need at least 2-4 weeks off work, but again this will be discussed with you on an individual basis.Avoid driving until the doctor tells you otherwise.Consult your doctor in case of increased pain, redness, watering or discharge or reduction of vision

DOES DIABETES CAUSE EYE PROBLEMS?

Yes. Some of the diseases it causes are diabetic retinopathy, glaucoma, cataract, infections, and refractive errors.

No symptoms at the early stage. Increase in floaters and even mild reduction in vision should be evaluated in diabetic patients.

Eye Surgery FAQ’s

What is presbyopia?

What is a multifocal lens?


Presbyopia is the condition in which the lens of the eye loses its ability to focus. It is a common condition that could accompany cataracts and impair your ability to see objects that are close up. Have you ever found yourself holding a menu or book farther away to read it? the need for reading glasses is usually a sign of presbyopia. This aging of the eyes eventually affects everyone. If you have cataracts with presbyopia, the lens can correct both conditions.


Multifocal lens is a breakthrough lens for cataract surgery that lets patient see from near to far, usually without glasses. It is effective when placed in both eyes. Most of the multifocal lens patients find that they can read a book, work on the computer, drive a car – day or night – and play golf or tennis with an increased freedom from glasses. You my experience visual disturbances in low lighting conditions, therefore increased care should be taken when driving at night

Normal Vision Vision with Cataract(simulated)

Implantable Contact Lens (ICL)

Frequently Asked Questions about the ICL

i 20x20How do I know if I am a suitable ICL candidate?

i 20x20Where is the ICL placed?

i 20x20What is Toric ICL?

i 20x20Does it hurt?

i 20x20What is the ICL made of?

i 20x20What if my vision changes after I receive the ICL?

i 20x20What type of procedure is involved in implanting the ICL?

i 20x20Can the ICL be removed from my eye?

i 20x20Is the ICL visible to others?

i 20x20Will I be able to feel the ICL once it is in place?

i 20x20Where can I get my ICL procedure done?

i 20x20What is the surety that I would not get back any of the numbers after the treatment? That is, is this a permanent solution? I would not be required to wear any lenses / specs after the treatment?

i 20x20Would there be any reaction due to the lenses being implanted – like my eyes not accepting the lenses, irritation in eyes, itchiness etc.

i 20x20Since I am working, I need to plan my days off from work. So, how many days rest am I required to take post treatment?


Candidates for the ICL are between 21 and 45 years of age, suffer from myopia (nearsightedness), hyperopia (farsightedness) and/or astigmatism (cylindrical power) and want to experience superior vision correction. The ideal ICL candidate has not undergone any ophthalmic surgery (though your surgeon might opt to do it as a secondary procedure in certain select cases) and does not have a history of eye disease such as iritis, glaucoma, or diabetic retinopathy. Nearly anyone seeking clearer vision may be a ICL candidate, including those with special or extreme vision correction needs. Prospective person should consult his/her ophthalmologist (eye surgeon) for more information, including an assessment of their candidacy. Women who are pregnant or nursing should wait to have the ICL implanted. Lastly, those without a large enough anterior chamber depth or endothelial cell density may not be a good ICL candidate.


A trained ophthalmologist will insert the ICL through a small micro-incison, placing it inside the eye just behind the iris in front of the eye’s natural lens. The ICL is designed not to touch any internal eye structures and stay in place with no special care.


The Toric ICL is a only variant of ICL. Toric ICL corrects your nearsightedness as well as your astigmatism (cylindrical power) in one single procedure. Each lens is custom made to meet the needs of each individual eye.


No, most patients state that they are very comfortable throughout the procedure. Your ophthalmologist will use a topical anesthetic drop prior to the procedure and may choose to administer a light sedative as well.


The ICL is made of Collamer®, a highly biocompatible advanced lens material which contains a small amount of purified collagen. Collamer does not cause a reaction inside the eye and it contains an ultraviolet filter that provides protection to the eye. Collamer is a material proprietary to STAAR Surgical Company, the company that manufactures ICL.


One advantage of the ICL is that it offers treatment flexibility. If your vision changes dramatically after receiving the implant, your doctor can remove and replace it. If necessary, another procedure can be performed at any time. Patients can wear glasses or contact lenses as needed following treatment with the ICL. The implant does not treat presbyopia (difficulty with reading in people 40 and older), but you can use reading glasses as needed after receiving the ICL.


The implantation procedure for the ICL (Implantable Contact Lens) is refractive eye surgery that involves a procedure similar to the intraocular lens (IOL) implantation performed during cataract surgery. The main difference is that, unlike cataract surgery, the ICL eye surgery does not require the removal of the eye’s natural lens. The ICL procedure is a relatively short outpatient procedure that involves several important steps. The surgical procedure to implant the ICL is simple and nearly painless. As a ICL candidate, your doctor will prepare your eyes one to two weeks prior to surgery by using a laser to create a small opening between the lens and the front chamber of your eye (iridotomy). This allows fluid to pass between the two areas, thereby avoiding the buildup of intraocular pressure following the surgery. However, some surgeons choose to do this step on the same day of the surgery.The implantation procedure itself takes about 15-30 minutes and is performed on an outpatient basis, though you will have to make arrangements for someone to drive you to and from the procedure. You can expect to experience very little discomfort during the ICL implantation. You will undergo treatment while under a light topical or local anesthetic, perhaps with the addition of a mild sedative. Following surgery, you may use prescription eye drops or oral medication. The day after surgery, you will return to your doctor for a follow-up visit. You will also have follow-up visits one month and six months following the procedure. Although the ICL requires no special maintenance, you are encouraged to visit your eye doctor annually for check-ups following the ICL procedure.


Although the ICL is intended to remain in place permanently, a certified ophthalmologist can remove the implant in a very quick & short procedure.


No, the ICL is positioned behind the iris (the colored part of the eye), where it is invisible to both you and observers. Only your doctor will be able to tell that vision correction has taken place.


The ICL is designed to be completely unobtrusive after it is put in place. It stays in position by itself and does not interact with any of the eye’s structures.


Please be aware that ICL procedure is presently available at select centres & hospitals in India as it requires precision and skills. In our Hospital, Dr Anand Shroff, our Cornea and LASIK expert will guide you better if you are the right candidate for this procedure.


The same surety that you could hand me today that your spectacle powers will not change!. Please remember that the eye is an organ not doing static fixed focus work, but something dynamic. If powers shift in adulthood, these are usually not related to the shape of your eyes or measurements taken of the same. These are also largely due to lifestyle, working long hours on the PC, changing the utility of your visual work from computers to movie screens etc. Our duty is to make you aware that doing such activities without proper and necessary precautions will shift your powers slightly (not hugely, but yes, small powers may come into play). This is the reason why we shall insist that you use computer specific prescription when working long hours on the PC, take frequent breaks etc.


In our experience, we have not seen any adverse effects. Itchiness of the eyes is usually in the eye lids, this part is untouched in ICL or LASIK treatments. hence, if your eyes are prone to turning ‘red’ or getting ‘itchy’ or ‘dry’ this is the inherent nature of your eyes and the procedure does not aggravate or cause this.


If planned well, no more than 10 days are required for doing ICL as both eyes are not treated on the same day. All options will be discussed during the LASIK evaluation to determine which technology is most appropriate for you.

Macular Degeneration


Age-related Macular degeneration (AMD) is a disease associated with aging that gradually destroys sharp, central vision. The disease attacks the macula, the central area of the retina that allows a person to see fine detail. Individuals can lose all but the outermost peripheral vision, leaving dim images or black holes at the center of vision. Central vision is needed is needed for seeing objects clearly and for common daily tasks such as reading, driving, identifying faces and watching television. AMD is a leading cause of vision loss and legal blindness in adults over 60 in the United States.


Macular degeneration is diagnosed as either dry or wet. Dry AMD is more common than wet AMD, with about 90% of people having the dry type and 10% of people having the wet type. However, even though the wet type is less common, 90% of severe vision loss comes from the wet type and only 10% from the dry type.


Dry AMD occurs when the light-sensitive cells in the macula slowly break down, gradually blurring central vision in the affected eye. It is diagnosed when yellow deposits known as drusen accumulate in the macula. Dry AMD causes gradual central vision loss, but the loss usually is not as severe as can be found with the wet type.


Wet AMD occurs when abnormal blood vessels behind the retina start to grow under the macula. These new blood vessels tend to be very fragile and often leak blood and fluid. This blood and fluid raises the macula from its normal place at the back of the eye, causing scarring and permanent damage to light-sensitive retinal cells, which creates blind or blurry spots in the central vision.


The cause of AMD is not complemtely known. However, the greatest risk factor is age. The risk of having AMD increases with age, from 10% at age 50 to about 30% at age 75. Other factors that increase the risk of developing AMD include family history of AMD, smoking, diet, weight and race. Caucasians are much more likely to lose vision from AMD than other races (*NIH). Lifestyle practices like not smoking, eating a healthy diet high in green leafy vegetables and fish, exercising and maintaining normal weight and blood pressure may play a role in reducing the risk of developing AMD.


Especially with the dry form, symptoms may develop gradually. Also if only one eye is affected, a person may not notice changes in vision until the disease gets moderately worse because the unaffected eye helps to compensate for changes in vision. Having an annual eye exam is very important for detecting AMD and other ocular disorders early in their progression.

Symptoms of AMD may include blurred vision, a dark area or “blind spot”, or a distorted appearance of straight lines or other objects. It is important for people with AMD to monitor their vision closely and to call their eye doctor if there is a change in vision. One way to monitor vision or detect a problem is with an Amsler grid. The Amsler grid, which looks similar to a section of graph paper, is a diagnostic tool that aids in the detection of visual disturbances caused by changes in the retina. The Amsler grid is a very sensitive test that can reveal clinical changes before other visual symptoms develop. With new and reliable treatments for wet AMD, this tool is important for the early detection of wet AMD..


The National Eye Institute’s Age-Related Eye Disease Study (AREDS) found that taking a specific high-dose formulation of antioxidants and zinc can reduce the risk of progression of dry AMD in some patients. The AREDS formulation is not a cure for AMD. It will not restore vision already lost from the disease. However, it may delay the onset of advanced AMD. It may also help people who are at high risk for developing advanced AMD keep their vision.


Wet AMD can be treated with laser therapy, photodynamic therapy, and injections into the eye. Some patients receive one of these treatments and some patients receive a combination of these treatments. None of these treatments is a cure for wet AMD, but they may halt the progression of the disease and in some cases allow for some gain in visual acuity.


This procedure uses a high energy beam of light to seal or destroy the abnormal blood vessels to prevent leaking and further loss of vision. However, laser treatment may also destroy some surrounding healthy tissue and some vision. Therefore, only a small percentage of people with wet AMD are treated with laser surgery- mainly those whose leaky blood vessels have developed away from the central part of the macula. The risk of new blood vessels developing after laser treatment is high and repeated treatments may be necessary.


This procedure uses a combination of light and drug therapy to destroy leaking blood vessels. First a drug called Verteporfin is injected into a patients arm. It travels throughout the body, including to the eye, where it “sticks” to the surface of new leaky blood vessels. Next, a light is shone into the eye for about 90 seconds. The light activates the drug which destroys the new blood vessels, leading to a slower rate of visual decline. Unlike laser surgery, the drug does not destroy surrounding healthy tissue. This therapy slows the rate of vision loss, but does not stop vision loss altogether or restore vision in eyes already damaged by AMD. Treatment results are often temporary and may need to be repeated.


The treatment of AMD has evolved in the last 5 or so years from limiting the degree of vision loss to maintaining and even improving existing vision in some cases. This is due in no small part to Anti-VEGF (Vascular Endothelial Growth Factor) therapy. Anti-VEGF therapy works by blocking the action of VEGF, the molecule that promotes the growth of abnormal blood vessels under the retina. These drugs are injected directly inside the eye to provide maximum concentration in the area where they are needed. The eye is numbed before each injection. There may be slight discomfort and soreness on the day of the injection, but not pain. Multiple injections will be given as often as monthly, with the goal of achieving up to 3 to 6 months between injections. These drugs maintain vision in up to 90% of all patients treated. Vision may improve in up to 1/3 of treated patients.

Diabetic Eye Disease



With diabetes, the body can’t use or store sugar properly. Diabetes damages the blood vessels in the eye. The damage of the blood vessels causes diabetic retinopathy. In later stages, the disease may lead to new blood vessel growth over the retina. The new blood vessels can cause scar tissue to develop, which can pull the retina away from the back of the eye. This is known as retinal detachment, and it can lead to blindness if untreated. The presence and severity of diabetic retinopathy is related to the duration of diabetes. However, severe and significant diabetic retinopathy can be present at the time of diagnosis especially with adult onset diabetes.


Everyone who has diabetes is at risk for developing diabetic retinopathy. In the early or advanced stages of diabetes, symptoms may be absent or minimal. Therefore, regular diabetic screening evaluations are recommended. The symptoms of diabetic retinopathy can include floaters, blurred vision or double vision. Sometimes difficulty reading or doing close work can indicate that fluid is collecting in the macula, the most light-sensitive part of the retina. This fluid buildup is called macular edema.


The severity of diabetic retinopathy can be limited or prevented by close monitoring and control of blood sugars, blood pressures and blood lipids, such as cholesterol. Control of any one of these risk factors can reduce the severity of diabetic retinopathy. According to the American Academy of Ophthalmology, 95% of those with significant diabetic retinopathy can avoid substantial vision loss if they are treated in time. The possibility of early detection is why it is so important for diabetics to have a dilated eye exam at least once a year. Diabetic retinopathy can be treated with laser photocoagulation to seal off leaking blood vessels and destroy new growth. Laser photocoagulation doesn’t cause pain, because the retina does not contain nerve endings. In some patients, blood leaks into the vitreous humor and clouds vision. A procedure called a vitrectomy removes blood that has leaked into the vitreous humor. The body gradually replaces lost vitreous humor, and vision usually improves.

Glaucoma

Glaucoma
Glaucoma is a condition that results in slow progressive damage to the optic nerve, which sends information from the eye to the brain. Damage to the optic nerve leads to a slow loss of vision. As a result, glaucoma is often referred to as The Silent Thief of Sight. Rick factors for glaucoma include elevated eye pressure, increased age, African-American heritage, and previous ocular injury. The most important and most treatable risk factor for glaucoma is elevated eye pressure. Inside the eye, there is a constant production of fluid that normally flows out of the eye through a very small drain. In certain individuals, this drain can become blocked for various reasons. The result is an increase in eye pressure, therefore increasing your risk of glaucoma. Glaucoma affects an estimated 3 million Americans and is the second-leading cause of blindness in the United States.

Types of Glaucoma

Open-Angle Glaucoma: Open-angle glaucoma occurs slowly as the drainage area in the eye becomes clogged. Pressure builds up when the fluid inside the eye is unable to drain. Side (peripheral) vision is damaged gradually. Open-angle glaucoma is the most common kind of glaucoma. Closed-Angle Glaucoma: With closed-angle glaucoma, eye pressure builds up rapidly when the drainage area of the eye suddenly becomes blocked. Blurry vision, rainbow halos around lights, headaches or severe pain may occur with closed-angle glaucoma. This type of glaucoma is less common than open-angle and may cause blindness if it is not treated immediately.

Questions and Answers

Careful examination of the optic nerve coupled with visual field testing and intraocular pressure measurement provides the necessary information to determine if damage from glaucoma is present. No. In fact, people with significant levels of damage may not have visual symptoms until most of the optic nerve function is lost. This is because the disease process is generally very slow, giving glaucoma the nickname “The Silent Thief of Sight”. In most cases, damage occurs to side (peripheral) vision first, and one eye may have significant field loss, but the other does not, so with both eyes open a person may not realize the extent of the damage. The two most important things you can do if you are diagnosed with glaucoma are to keep follow-up appointments and faithfully use ocular medications as prescribed. Careful monitoring and consistent treatment can often stabilize this disease process.

LASIK


In a normal eye, light entering the eye is refracted (bent) first by the eye’s cornea and then by the eye’s natural lens so that it focuses precisely on the retina. The retina is the sensitive tissue on the back of the eye that converts light images into electrical impulses and sends them through the optic nerve to the brain. If the light rays are not focused precisely on the retina, the result is refractive error, or poor vision in the form of nearsightedness, farsightedness or astigmatism.

Nearsightedness occurs when the eye’s cornea is shaped too steeply, or the eye is too long. Incoming light rays are refracted to a focal point in front of the retina instead of on the retina. This results in distant objects being out of focus, while close objects can be seen clearly.


Farsightedness is the reverse of nearsightedness. Instead of a cornea that is too steep, the farsighted eye has a cornea that is too flat, or the eye is too short. Light rays refracted through the cornea converge at a focal point behind the retina. This results in close objects being out of focus while distant objects are more clear.

Astigmatism is the result of an aspheric (irregularly shaped) cornea that scatters light rays as they enter the eye. An astigmatic cornea has an oblong shape like a football instead of a round shape like a basketball. The result is that there is no single focal point, and vision is blurry both near and far.


Presbyopia refers to the normal process of aging in which the natural lens inside the eye becomes hardened. As this occurs, the lens loses its flexibility, which makes reading difficult. This usually occurs between the ages of 40 and 50. Everyone experiences presbyopia. The result of this normal process is bifocals for those who wear glasses or contacts, and reading glasses for those who have not needed corrective lenses previously. LASIK surgery will not correct presbyopia.


Wearing corrective lenses merely treats the symptoms of nearsightedness, farsightedness and astigmatism. The lenses do not correct the refractive error. Those with nearsightedness, farsightedness and astigmatism can benefit from refractive surgery because refractive surgery corrects the error by enhancing the eye’s ability to refract light rays precisely onto the retina. Many people think that LASIK is the only type of refractive surgery, and today LASIK is the most commonly performed corrective eye surgery in the United States, but in truth, there are many different procedures to choose from. Refractive surgery, also known as corrective eye surgery, encompasses a multitude of procedures designed to treat and correct refractive errors including nearsightedness, farsightedness and astigmatism. In each of these procedures, a laser is used to reshape the cornea to alter the way light rays enter the eye to achieve focus. The process used, however, differs from surgeon to surgeon.


Laser in situ keratomileusis, or LASIK, is the most commonly performed refractive surgery procedure today and is the primary procedure of choice at Wolfe Eye Clinic. LASIK has advantages over other procedures, including a relative lack of pain and the fact that good vision is usually achieved almost immediately or in a very short period of time. Those with nearsightedness, farsightedness and astigmatism can benefit from LASIK. During LASIK surgery, a thin flap of tissue is created on the center of the cornea (Figure 1). This flap is then lifted back to expose the internal tissue, or stroma, of the cornea. An excimer laser is then used to reshape the cornea and correct the refractive disorder (Figure 2). The flap is then layed back over the cornea where it heals itself in a very short period of time (Figure 3). With LASIK, the instrument used to create the flap varies. Most surgeons use an instrument called a microkeratome. A microkeratome is a device that uses a very sharp oscillating blade to cut the flap. Other surgeons, including those at Wolfe Eye Clinic, prefer a more advanced bladeless technique, using a very precise laser to create the flap instead. Wolfe Eye Clinic surgeons use the IntraLase laser to create the flap during LASIK surgery. The Zyoptix z-100 is a major advance in treatment. It has advanced safety features that include iris recognition that ensures treatment for the correct eye and rotational eye tracker that ensures greater precision. This treatment is twice as fast and is suitable for a greater variety of abnormalities. It affords excellent results.
The advantages include:

bullet-blueIris Recognition- Greater accuracy of treatment placement

bullet-blueAutomatic patient identification ensures correct eye is treated

bullet-blueZy-ID – A unique digital ‘map’ of the iris, individual to every patient

bullet-blueMultidimensional Eye tracker- Compensates and corrects for intra-operative eye-movement in every dimension, including cyclotorsion and pupil shift

bullet-blue100Hz Laser- For significantly faster treatment times

bullet-blueTreatment planner- For wide range of treatment options

bullet-blueLED Illuminations- For greater pupil iris contrast, greater surgical visibility and improved comfort for patients and surgeons

bullet-blueZeiss Microscope- Increases visibility by allowing for 3 levels of magnification.

With the latest technology at the hands of skilled professionals, the Centre ensures the best results possible.



Photorefractive keratectomy, or PRK, was the first refractive procedure that utilized the excimer laser to reshape the front surface of the cornea. It was initially envisioned in 1983 and, after a long series of clinical trials, was approved by the FDA in 1995. PRK however is primarily used to correct mild to moderate cases of nearsightedness and astigmatism. After the eye has been anesthetized with topical eye drops, your doctor prepares the eye by removing the surface layer of the cornea called the epithelium. This layer naturally regenerates itself every few days. Pulses of laser light are then applied to the surface of the cornea to reshape the curvature of the eye. Postoperatively, patients typically wear a bandage contact lens for the first three to five days to reduce postoperative pain and irritation. Anti-inflammatory eye drops are used in a decreasing dose for several months. Vision is usually blurry initially and starts to clear over the first several weeks, while continuing to improve for up to one year.


Laser Epithelial keratomileusis, or LASEK, is a laser procedure that is used mostly for people with corneas that are too thin or too flat for traditional LASIK. It was developed to reduce the chance of complications that occur when the flap created during LASIK is not the ideal thickness or diameter. In LASEK, the epithelium, or outer layer of the cornea, is cut not with the microkeratome blade or laser used in LASIK, but with a blade called a trephine. Next, the surgeon covers the eye with an alcohol solution for around 30 seconds. The solution loosens the edges of the epithelium. After sponging the alcohol solution from the eye, the surgeon uses a tiny tool to lift the edge of the epithelial flap and fold it back out of the way. Then the surgeon uses an excimer laser, as in LASIK or PRK, to apply pulses of laser light that sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye. There is a possibility of a reaction to the alcohol that may kill some of the epithelial cells. Patients typically wear a bandage contact lens for around four days and may feel eye irritation during the first few days afterward. The time it takes to recover good vision is up to four to seven days longer than with LASIK.


Epi-LASIK is a cross between LASIK and LASEK. During Epi-LASIK, a flap is cut in the cornea’s outer layer, just as in LASIK and LASEK. However, with Epi-LASIK the surgeon uses a blunt, plastic oscillating blade. Instead of the alcohol that is used in LASEK to loosen the epithelial sheet, during Epi-LASIK the surgeon uses the blunt plastic blade, called an epithelial separator, to scrape the sheet across the eye. Next, the surgeon uses an excimer laser, as in LASIK, LASEK or PRK, to apply pulses of laser light that sculpt the corneal tissue underneath. Afterward, the epithelial flap is placed back on the eye. Then, a special contact lens is placed on the eye to keep the flap in place while it re-epithelializes. Vision will probably be cloudy or variable at first, unlike traditional LASIK. Some patients report good vision within a week or two, while others take three to six months to reach their final result. These recovery times are significantly longer than with LASIK, which usually allows people to achieve good vision from the same day up to a few weeks later and to drive by the day afterward.


LASIK surgery is not an option for everyone. A very high refractive error, thin corneas or severe dry eye may prohibit someone from being a good LASIK candidate. Fortunately, implantable lenses may provide an alternative. Examples of these lenses include the Verisyse™ Intraocular Lens, Visian’s Intraocular Collamer Lens, Alcon’s Acrysof® ReSTOR® Intraocular Lens and the ReZoom™ multi-focal Intraocular Lens. Unlike LASIK, which reshapes the outer part of the eye, lens implants are inserted inside the eye. Once in place, the lens stays in place indefinitely and should require no maintenance.

Cataract

Besides conventional extracapsular cataract extraction,this centre is also performing world class small incision sutureless cataract surgery (phaco),with foldable IOL including multi focal leading to greater patient satisfaction.well experienced and highly skilled cataract surgeons of this hospital have changed the lives of thousands of patients who underwent cataract surgery in this centre A cataract occurs when the normally clear lens of the eye becomes cloudy and interferes with light passing through the eye. Cataracts are a process of aging and usually begin developing around midlife. Approximately 70% of people over the age of 60 and 90% of people over 70 will develop cataracts. The process is generally gradual, and people often do not realize what is happening until they have an eye exam. Common symptoms of cataracts may include blurry vision, glare and reduced vision in bright light, halos around light, poor night vision or fading of colors. Untreated, cataracts are a common cause of blindness.

i 20x20How is a Cataract Removed?

i 20x20What is an Intraocular Lens?



Modern surgical techniques have made cataract removal one of the safest and most successful surgeries today. The virtually painless procedure takes about 10 minutes and is usually performed in a hospital on an outpatient basis. The eye is anesthetized using eyedrops, and a small incision (about one-eighth of an inch) is made in the white of the eye or through the outer edge of the cornea. An ultrasonic instrument is inserted and used to emulsify, or break up, the cataract and then vacuum away the damaged material. After the cataract has been removed, the surgeon inserts an intraocular lens to replace the natural lens that was removed. The day after surgery you will return for a checkup and your doctor may ask you to return later for one or more follow-up examinations and vision tests. Most patients notice an improvement in their vision during the first few days after surgery.


An intraocular lens (IOL) is usually implanted during cataract surgery to replace the clouded natural lens that is being removed. A comprehensive eye examination prior to surgery and discussion with your doctor will determine what type, size and power of IOL is needed. The prescription lens implants are made from a flexible plastic that can be folded and inserted into the same small incision used to remove the cataract. The IOL is held in place inside the eye by tiny wires attached to the implant. Once the lens is implanted, it functions similarly to a natural lens and usually is not detectable to the patient. A cataract occurs when the normally clear lens of the eye becomes cloudy and interferes with light passing through the eye. Cataracts are a process of aging and usually begin developing around midlife. Approximately 70% of people over the age of 60 and 90% of people over 70 will develop cataracts. The process is generally gradual, and people often do not realize what is happening until they have an eye exam. Common symptoms of cataracts may include blurry vision, glare and reduced vision in bright light, halos around light, poor night vision or fading of colors. Untreated, cataracts are a common cause of blindness.