Call now! | Lasik Surgery by the Experts | W Pratiksha Hospital | Gurgaon
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Ophthalmology

OPHTHALMOLOGY
Overview

At W Hospital’s Ophthalmology department, we offer general eye care consultation as well as super specialty eye care consultations in cataract, refractive surgeries, squint and glaucoma.

All the doctors in the department are very patient friendly with one to one interaction with adequate time given to all patients till their queries are cleared. They believe in treating the patient as clinicians and not ordering unnecessary investigations. Special attention is given to children to ensure their entire visit is pleasant and stress free.

Team
Freedom from Glasses

Tired of wearing glasses/contact lenses/ intolerant to lenses and looking for a spectacle-free life? Please read the information below to help you make an informed decision and contact W hospital for more details.

The options available are:

  • LASIK: Conventional/Customized/Aspheric/ Thin Flap /Bladeless
  • Phakic IOL: ICL/IPCL
  • RLE: Refractive Lens Exchange

 

LASIK

LASIK stands for Laser Assisted In Situ Keratomilieusis. In simpler terms it reshapes the front portion of the eye called Cornea with the help of laser. A thin flap of cornea is raised, highly precise laser is delivered on cornea bed and the flap put back. There are no sutures or pain involved. A completely walk in walk out procedure.

 

Types of Lasik

  • Conventional Lasik: Here only the number is removed.
  • Customised Lasik: Here along with the number the corneal irregularities are also removed.
  • Asperic Lasik: Here Along with number & irregularities, cornea is reshaped almost like normal cornea.
  • Thin Flap Lasik: Any of the above three can be done but with special thin flap blade in persons with thin corneas or high numbers.
  • Bladeless Lasik (Femto Lasik): Double laser Lasik where the Lasik flap is also made with laser in addition to the laser for removal of number.

 

Who can undergo Lasik?

  • Anybody not wanting to wear glasses or contact lenses and who satisfy following criteria.
  • More than 18 years of age.
  • Stable number for last 6 months.
  • Not pregnant or post delivery more than 6 months.
  • Having Adequate thickness of cornea.
  • Preferably having Spectacle power of -1 to -8D or +1 to +6D or Cyl of 1 to 6D.

 

Pre LASIK Workup (Mandatory before surgery)

Involves detailed eye examination including : spectacle power check with and without cycloplegia, corneal thickness measurement – Pachymetry, corneal mapping- topography – aberrometry & Pentacam, measurement of Intraocular pressure, eyelid & tear film assessment, any squint, pupil size, dilated Retinal examination.

If you are a contact lens wearer then soft lenses should be discontinued at least one week and RGP (semisoft) contact lens at least 2 weeks before this eye check-up and Lasik procedure. This examination determines whether you are a suitable candidate or not.

 

LASIK Procedure

The procedure essentially involves making and lifting a flap of cornea, doing laser and sticking the flap back without any stitches. Normally takes 8-10 min for one eye and one can go home almost immediately.

 

Post LASIK Care

The patient can resume routine activities the very next day. No dietary restrictions. Only washing and rubbing of eyes is prohibited for 1 month.

 

Long Term Effects

There are no serious long term side effects and the safety profile of the procedure is excellent because of the investigations which are routinely done before surgery. Majority of the people develop dryness of the eye which resolves in a few weeks depending on the preoperative condition of the eye. LASIK corrects number only for distance hence one would need reading glasses after 40 years of age.

 

PHAKIC IOL

Phakic IOL is an Intraocular lens (IOL) implanted inside the eye with the natural lens in situ i.e. between the iris and the natural lens to correct spectacle power.Two types of Phakic IOLs are being offered by us:

  • ICL (Implantable Collamer Lens).
  • IPCL (Implantable Phakic Contact Lens).

 

Who can undergo Phakic IOL?

Anybody not wanting to wear glasses or contact lenses and fall into following categories:

  • Age between 21 and 45 years.
  • Have Myopia (-4 to -20 sphere) with or without Astigmatism (1 to 4 Cyl) and Hyperopia (+3 to +10sphere).
  • Stable glasses number for more than a year.
  • Adequate anterior chamber depth.
  • Not pregnant or post delivery more than 6 months.
  • Patients not fit for LASIK due to weak/thin cornea or post C3R for keratoconus.

 

Pre Phakic IOL Workup

Similar to LASIK. Only additional thing measured is size of cornea and space in the front portion of the eye along with goniscopy.

 

Phakic IOL Procedure

The implantation procedure itself takes about 15 minutes and is performed on an outpatient basis under a light topical or local anesthetic wherein the is placed between the natural lens and the coloured part of the eye, Iris. The lens is not visible to anyone.

 

Long Term Effects

Some patients can develop increase in the pressure of the eye which is taken care off with medicines. In less than 1% cases cataract changes can get enhanced.

 

Post Phakic IOL Care

Same as LASIK

 

REFRACTIVE LENS EXCHANGE

Refractive lens exchange (RLE) or Clear lens extraction (CLE) is the removal of natural clear non-cataractous lens of the eye with intraocular lens implantation as a refractive procedure to correct spectacle power.

 

Eligible candidate for RLE

Patients 18-40 yrs of age with high myopia and high hyperopia (12 to 30 diopters) which is not manageable by LASIK or Phakic IOL.

Also done for patients above 40 yrs who do not want to wear glasses for near vision by putting Multifocal and accommodative IOLs.

 

RLE Procedure

RLE is similar to any other cataract procedure under local anaesthetic eye drops. The natural lens matter is aspirated and replaced with refractive intraocular lens. Like cataract, it is a day care surgery.

 

Advantages of RLE

A person with very high spectacles power of say -20 or +15 dioptres is completely dependent on glasses or contact lens. For them, it is a boon to be able to see well and get rid of the burden of heavy glasses or daily chore of managing the contact lenses. The predictability, stability, ease of technique and better quality of vision, coupled with use of toric or multifocal lens technologies and advantages of small-incision surgery, makes it a viable option for getting rid of very high glasses number at a very reasonable cost.

 

Long Term Effects

A thorough check-up of the retinal periphery is mandatorily done with retinal laser for any hole or break detected to prevent the remote possibility of retinal detachment. This is especially for high minus numbers. There no such concerns for patients with high plus numbers. Rest of the risks & complications are same as any cataract surgery.

Cataract

What is cataract?

Cataract is the opacification /clouding of normal clear lens in the eye.

 

Why does it happen?

Most common cause is aging. It can also happen due to injury to the eye, steroid eye drops or tablets, metabolic diseases like diabetes etc. It may be present at birth also in some children.

 

Symptoms

Main symptom is Blurring of vision, Inability to see in very bright or dull light, frequent change of glasses.

 

Treatment

Surgery is the only treatment for cataract besides change of glasses in the initial period. The preferred treatment option is Phacoemulsification with foldable IOL.

 

Appropriate time for surgery

A common myth is that cataract should be removed only once it matures. On the contrary the cataract should not be allowed to mature as it causes more damage to eye during removal and can have problems in implanting the IOL (Lens).The cataract should be removed as and when it causes visual disability to the person and starts hindering in day today life / fouund to be hard on routine examination by the ophthalmologist. There is no season for cataract surgery. Since Phaco & MICS are done through very small incision, the healing, recovery and chances of infection are very low and can be done any time of the year.

 

Types of Phacoemulsification

  • Normal Phacoemulsification: Keyhole surgery, also called incorrectly as Laser cataract surgery. Done through a 2.8 mm incision with implantation of the foldable IOL without stitches.
  • Micro Incision Cataract Surgery: Advanced cataract surgery done through a < 2.0 mm incision for fast healing and minimal distortion of the cornea.
  • Laser Phaco / Laser Cataract Surgery: Bladeless Phacoemulsification surgery where all the cuts and breaking of cataract is done by laser. Laser surgery in true sense and a really advanced technique for those who desire perfection.

All these surgeries are routinely done without injection anesthesia

 

Types Of IOLS ( Intra Ocular Lenses)

  • Monofocal IOL: Give good vision for distance.
  • Multifocal IOL: Give good vision for distance as well near reducing dependence on glasses.
  • Toric IOL: Correct the cylindrical power of the cornea in addition to distance power or distance & near power.

 

Recovery After Surgery

It’s a daycare surgery even in insurance patients and reqires only a few hours of admission. The recovery is almost immediate. Vision returns before going home itself. No bandage is needed at home. Final glasses prescription if needed is given 2-3 weeks after the surgery.

 

Common Myths about Cataract Surgery

  • There are no restrictions on the day today life of the person including diet.
  • Cataract doesn’t happen again.
  • Second eye can be operated as soon as one is comfortable with the first eye, as early as 2 days.
  • Even both eyes can be done simultaneously in patients who have difficulty in moving around.
  • IOL has no expiry. Its life long.
  • A person may need glasses despite the IOL depending on the IOL implanted.
Glaucoma

Glaucoma Or Kala Motia is a disease of the eye in which the nerve of the eye gets damaged due to its inability to withstand the pressure of the watery liquid inside the eye. In majority of the cases the pressure of the eye is higher than normal but in some cases, even normal eye pressure can damage the nerve of the eye. If not treated on time Glaucoma can lead to Irreversible blindness.

 

Common Types Of Glaucoma

  • Angle Closure Glaucoma: Happens due to blockage of the drainage system. Here the eye pressure can rises sharply and causes, pain, blurring of vision and coloured haloes around light.
  • Open Angle Glaucoma: Happens due to choking of the drainage system. A silent killer has no symptomps till near the end stage. Detected only by an Ophthalmologist.
  • Normal Tension Glaucoma: Here the nerve is so weak that even normal eye pressure damages it. Hence must be shown to an ophthalmologist.

 

Who is at risk?

  • Person having family history of glaucoma.
  • Persons wearing high plus or minus glasses.
  • Persons suffering from Diabetes or Hypertension.
  • Persons using steroid eye drops for a long time.

 

Diagnosing Glaucoma

The Initial assessment includes Tonometery (Eye pressure measurement), Central Corneal Thickness ( CCT), Gonioscopy, and Fundus Examination.

 

Additional tests required from time to time are:

  • OCT: This measures the actual size of the optic disc and gives us objective data about the quantum of structural damage to the nerve of the eye.
  • Perimetery: It evaluates the function of the optic nerve and gives the data about the functional damage to the nerve of the eye. It can pick up damage to the optic nerve in the early stages itself.

 

Treatment

The treatment is usually involves putting eye drops on a regular basis and regular follow-ups to assess any increase in the damage to the nerve. Some cases especially of Angle Closure Glaucoma variety need Laser Procedures.

In advanced cases or in patients not being able to tolerate medicines Surgery is done.

 

IMPORTANT: Glaucoma leads to permanent blindness in majority of the cases but regular medication and check-up can easily prevent a person from becoming blind.

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