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Phacoemulsification Cataract Surgery(Phaco)
Phaco is the most common technique used in modern cataract surgery. It involves the use of a Phaco machine with an ultrasonic handpiece equipped with a titanium or steel tip. This tip can enter eye with 2.8 mm incision (Scientifically any incision smaller than this has no added advantage on post-operative vision), this tip emulsifies (powders) the lens into very tiny fragments which can be removed through same tip.
In this surgery;
· No injection to numb the eye is required.
· No eye pad after surgery
· Patient can go home same day
· Watching TV, Mobile can be started from next day
· No restriction for eating. Can have normal diet including Non-Vegetarian food, Salads like radish, Carrot and fruits.
· Bathing from head can be done from 5th day
· Vision is better after surgery itself, it improves rapidly
· Prescription glasses are not required after surgery.
Video of Cataract Surgery with Panoptix Lens implantation performed by Dr Pratyush Ranjan:
Femtosecond laser-assisted cataract surgery
Femtosecond laser-assisted cataract surgery has been shown to have no visual, refractive or safety benefit over phacoemulsification surgery.
In a multicenter case-control study, Manning et al. compared the visual, refractive, and adverse outcomes of femtosecond laser–assisted cataract surgery (FLACS) and conventional phacoemulsification cataract surgery. They found that FLACS did not yield better visual or refractive outcomes than conventional phaco.
https://www.aao.org/eyenet/article/flacs-vs-standard-phacoemulsification-cataract-sur
The Ranjan’s Modified Manual Small Incision cataract surgery (R -MSICS)
The Ranjan’s Modified Manual Small Incision cataract surgery (R -MSICS) is developed by yours truly by a continuous active innovative process. R-MSICS has done away with all unnecessary steps, enabling it to be performed in less time with excellent visual outcome. The post-operative astigmatism can be further reduced by using Ranjan MSICS Marker, which also helps in doing MSICS topically making it a truly refractive surgery.
In this surgery;
· No injection to numb the eye is required.
· No eye pad after surgery
· Patient can go home same day
· Watching TV, Mobile can be started from next day
· No restriction for eating. Can have normal diet including Non-Vegetarian food, Salads like radish, Carrot and fruits.
· Bathing from head can be done from 30th day
· Vision is better after surgery itself, it improves rapidly and by 7th day full vision is achieved
· Prescription glasses are required after surgery
Video of The Ranjan’s Modified Manual Small Incision cataract surgery performed using Ranjan MSICS Marker, developed by Dr Pratyush Ranjan Can be watched here:
Manual small incision cataract surgery (MSICS)
This technique is an evolution of ECCE (see below) where the entire lens is expressed out of the eye through a self-sealing scleral tunnel wound. An appropriately constructed scleral tunnel is watertight and does not require suturing. The "small" in the title refers to the wound being relatively smaller than an ECCE, although it is still markedly larger than a phaco wound. Head-to-head trials of MSICS vs phaco in dense cataracts have found no difference in outcomes, but shorter operating time and significantly lower costs with MSICS.
In this surgery;
· No injection to numb the eye is required.
· No eye pad after surgery
· Patient can go home same day
· Watching TV, Mobile can be started from next day
· No restriction for eating. Can have normal diet including Non-Vegetarian food, Salads like radish, Carrot and fruits.
· Bathing from head can be done from 30th day
· Vision is better after surgery itself, it improves rapidly
· Prescription glasses are required after surgery
Extracapsular cataract extraction (ECCE)
Extracapsular cataract extraction involves the removal of almost the entire natural lens while the elastic lens capsule (posterior capsule) is left intact to allow implantation of an intraocular lens. It involves manual expression of the lens through a large (usually 10–12 mm) incision made in the cornea or sclera. Although it requires a larger incision and the use of stitches, the conventional method may be indicated for patients with very hard cataracts or other situations in which phacoemulsification is problematic.
In this surgery;
· Injection to numb the eye is required.
. Five or more Sutures are applied, which may be removed after 30 days
· Eye pad is required after surgery
· Patient can go home same day, if they live in same city
· Bathing from head can be done from 30 days
· Prescription glasses are required after surgery to see.
Intracapsular cataract extraction (ICCE)
Intracapsular cataract extraction (ICCE) involves the removal of the lens and the surrounding lens capsule in one piece. The procedure has a relatively high rate of complications due to the large incision required and pressure placed on the vitreous body. It has therefore been largely superseded and is rarely performed.
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Dr Pratyush Ranjan-MBBS, DO MS, DNB MAMS Cataract, Refractive and Glaucoma Specialist