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Small Incision Cataract Surgery

Cataracts can impair your vision, making simple daily activities challenging. Small incision cataract surgery is a state-of-the-art procedure that can help restore your sight by removing the cataract using a minimal incision, promoting faster recovery and fewer complications. At Pristyn Care, our skilled ophthalmologists are adept at performing small incision cataract surgery using advanced techniques. Don't let cataracts cloud your vision; book an appointment today with our experienced doctors for comprehensive eye care.

Cataracts can impair your vision, making simple daily activities challenging. Small incision cataract ... Read More

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What Is Small Incision Cataract Surgery?

Small incision cataract surgery (SICS) is a modern intervention used to treat cataracts. A cataract causes the lens of the eye to become cloudy, leading to blurry or distorted vision. If left untreated, it can significantly impact your quality of life. When your sight is affected to such an extent that performing daily activities becomes difficult, your doctor may recommend small incision cataract surgery.

Performed by an ophthalmologist, small incision cataract surgery requires a smaller incision compared to traditional methods, which brings several benefits including shorter recovery times and reduced risk of complications. The surgery involves removing the clouded lens and replacing it with an artificial intraocular lens (IOL). This procedure is usually conducted on an outpatient basis, meaning you don’t need to stay overnight at the hospital. With a high success rate, small incision cataract surgery is considered not only safe but very effective in treating cataracts.

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What Are The Types of Small Incision Cataract Surgery?

The approach for small incision cataract surgery varies based on several factors including the severity of the cataract, the patient’s eye health, and the surgeon’s expertise. Below are the primary types of small incision cataract surgery:

  • Manual Small Incision Cataract Surgery (MSICS): MSICS involves the surgeon manually creating a small incision, typically of 5-7mm, in the cornea or sclera to access the cataract. The lens is then removed using a technique such as extracapsular cataract extraction (ECCE), and an intraocular lens (IOL) is implanted into the eye.
  • Phacoemulsification (Phaco): The most common technique used for cataract surgery, phacoemulsification utilises ultrasonic energy to fragment the cataract into small pieces for easy removal. A foldable IOL is then inserted through the small incision.
  • Micro Incision Cataract Surgery (MICS): An advanced form of phacoemulsification, MICS employs even smaller incisions (1.8-2.2 mm), leading to reduced trauma to the eye and faster recovery times.
  • Laser-Assisted Cataract Surgery: This method uses a femtosecond laser to perform key steps of the surgery with greater precision. The laser assists in creating the initial corneal incision, performing the capsulotomy, and fragmenting the cataract before removal.

Sutureless Cataract Surgery: In this technique, the incision made during cataract surgery is so small that it self-seals without the need for sutures, reducing postoperative discomfort and recovery time.

Diagnosis Before Small Incision Cataract Surgery

Before deciding on the need for a small incision cataract surgery, your eye specialist will conduct a comprehensive examination of your eyes. The process involves the following steps:

  • Patient History: Your doctor will review your previous medical history, current symptoms, and any past incidents related to eye disease or surgery.
  • Visual Acuity Test: This test, conducted using an eye chart, measures how well you can see at different distances.
  • Slit-Lamp Examination: Using a specialised instrument known as a slit lamp, the doctor will examine the structures of the eye, including the lens. This helps identify both the presence and type of cataract.
  • Retinal Examination: By widening your pupils using dilating drops, your doctor will have an enhanced view of your retina and optic nerve. This test assesses overall eye health.

Cataract Type Assessment: Based on distinct types of cataracts such as traumatic or hypermature cataracts, your doctor may suggest small incision cataract surgery due to their density or complexity.

What is the Procedure for Small Incision Cataract Surgery?

The small incision cataract surgery follows a particular sequence of steps:

  • Preparation: Patients undergo preoperative assessments including eye measurements for determining the appropriate IOL strength.
  • Anaesthesia: Local anaesthesia is typically administered to numb the eye. Sedation may also be provided for patient comfort.
  • Incision Creation: A small incision is made in the cornea or sclera to access the cataract.
  • Cataract Removal: Depending on the method used, the surgeon removes the cataract, either manually or through phacoemulsification or micro-incision.
  • Intraocular Lens Implantation: After removing the cataract, an IOL is inserted through the same incision.
  • Closure: The incision may be self-sealing or might require minimal suturing.

Postoperative Care: Patients receive instructions on eye care post-surgery to prevent infection and manage inflammation.

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Who is the Right Candidate for Small Incision Cataract Surgery?

A comprehensive evaluation by your ophthalmologist will determine if you are an eligible candidate for small incision cataract surgery. The criteria include:

  • Visual Symptoms: You might be suitable for surgery if cataracts have significantly affected your vision and daily activities, like reading or driving, and can’t be corrected with glasses or contact lenses.

Impact on Daily Life: If cataracts hinder your ability to perform essential daily activities or hamper your quality of life, you may be considered for cataract surgery.

What Are The Benefits Of Small Incision Cataract Surgery?

Small incision cataract surgery (SICS), inclusive of techniques such as Micro Incision Cataract Surgery (MICS) and Manual Small Incision Cataract Surgery (MSICS), have ushered in a new era of eye care with their numerous advantages. These benefits include:

  • Reduced Trauma: With smaller incisions, typically ranging between 1.8-2.2 mm for MICS, less trauma is caused to the eye, leading to faster healing and recovery than traditional methods that require larger incisions.
  • Swifter Recovery: Patients experience more rapid visual recovery and can return to their normal activities sooner. The smaller incision size also minimises postoperative discomfort and reduces the need for extensive follow-up visits.
  • Lower Risk of Astigmatism: Smaller incisions are linked with a reduced risk of surgically induced astigmatism, leading to improved overall visual outcomes and less dependence on corrective lenses post-surgery.
  • Compatibility with Advanced IOLs: MICS enables the use of premium intraocular lenses (IOLs), like multifocal or toric lenses, enhancing visual quality and reducing dependence on glasses.

Minimal Need for Sutures: Many small incision techniques are self-sealing, eliminating the need for sutures and related complications, which further simplifies recovery.

How To Prepare For Small Incision Cataract Surgery?

Before undergoing small incision cataract surgery, patients need to follow several steps:

  • Preoperative Assessment: A thorough eye examination is carried out, which includes visual acuity tests and measurements for IOL selection.
  • Medication Review: A conversation with the surgeon about the current medications being taken by the patient is essential; this includes over-the-counter medicines and supplements, as some may need to be discontinued before surgery.
  • Anaesthesia Consultation: A discussion about the type of anaesthesia to be used during the procedure is critical—local anaesthesia is commonly used, but sedation options may also be available.
  • Postoperative Arrangements: Be sure to arrange for someone to drive you home post-surgery, as your vision might be temporarily impaired.

Follow Preoperative Instructions: Adhere to any specific instructions provided by your surgeon about food and drink restrictions before surgery.

What Are The Recovery Tips and Precautions To Follow After Small Incision Cataract Surgery?

Recovery after small incision cataract surgery is generally smooth, but for optimal healing, it’s crucial to follow these tips:

  • Follow-Up Appointments: Attend all scheduled follow-ups to monitor healing progress and address any arising concerns.
  • Medication Compliance: Use prescribed eye drops or medications as directed to prevent infection and manage inflammation.
  • Avoid Strenuous Activities: Avoid heavy lifting, bending over, or strenuous exercise for a few weeks post-surgery.
  • Protective Eyewear: Wear sunglasses outdoors to protect your eyes from bright light and debris during the initial recovery phase.
  • Avoid Water Exposure: Avoid water contact with the eyes when showering or washing the face for at least a week post-surgery to prevent infection.

Monitor Symptoms: Watch out for signs of complications like increased pain, redness, or vision changes, and contact your doctor if these occur.

Potential Risks Or Complications Associated With Small Incision Cataract Surgery

While small incision cataract surgery is generally a safe procedure, there may be potential complications:

  • Infection: While rare, postoperative infections can happen, requiring immediate treatment.
  • Inflammation: Some patients might experience inflammation within the eye that requires medication to manage.
  • Retinal Detachment: A rare but serious complication that can occur post-cataract surgery, especially in patients with pre-existing risk factors.
  • Visual Disturbances: Some patients might experience glare, halos around lights, or fluctuating vision post-surgery.

Need for Additional Surgery: Additional procedures might be required if complications arise or if the initial surgery does not achieve the desired results.

FAQs

How long does it take to perform small incision cataract surgery?

Small incision cataract surgery is a swift procedure, typically completed within 15 to 30 minutes. However, the entire visit to the hospital may last a few hours, accounting for pre-surgical preparations and post-surgical monitoring.

Will I experience pain during the small incision cataract surgery?

You should not feel any pain during the surgery as local anaesthesia is used to numb your eye and the area around it. You may, however, experience slight discomfort or a sensation of pressure.

What happens after the small incision cataract surgery is done?

Post-surgery, your doctor will usually place a protective shield over your eye. You might have blurry vision initially, but it will improve within a few days. Your doctor will prescribe eye drops to help the healing process and prevent infection.

Will I be awake during the small incision cataract surgery?

Yes, you are likely to be awake during the procedure. However, you’ll receive local anaesthesia to numb your eye so you won’t feel any pain and mild sedation to help you relax.

When can I resume my regular activities after having small incision cataract surgery?

Most patients can resume their normal activities within a day or two after surgery. However, strenuous activities and heavy lifting should be avoided for at least a week.

Can both eyes undergo small incision cataract surgery at the same time?

Generally, it is advisable to wait for at least 1-2 weeks between surgeries on each eye. This allows one eye to heal properly before the other one is operated on.

How successful is small incision cataract surgery?

Small incision cataract surgery has a high success rate in restoring vision, with complications being rare. More than 95% of people report improved vision after the surgery.

How often do I need to visit the doctor after small incision cataract surgery?

Your first follow-up will usually be the day after surgery. Afterwards, you will need to see your doctor after a week and then again after a month to ensure your recovery is progressing well.

Can cataracts reappear after undergoing small incision cataract surgery?

No, once a cataract has been removed, it cannot grow back. However, some patients may experience a condition known as secondary cataract, where vision can become cloudy again. This is treatable with a simple and painless laser procedure.

Will I need glasses after small incision cataract surgery?

Whether or not you need glasses post-surgery depends on the type of intraocular lens that was implanted during the procedure. Some patients might still need glasses for reading or distant vision.

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