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Stitchless Cataract Surgery

Dr. Pradnya Kanase, Chief ophthalmologist at Apex Eye Care Clinic (located at Balewadi Phata,Baner,Pune) specializes stitchless cataract surgery.

“Cataract is leading cause of blindness worldwide, it is important for patients and family to understand what causes cataract, its symptoms and how it can be treated. At Apex Eye Care Clinic, we educate people about the treatment options, ”Dr. Pradnya Kanase.

Dr. Pradnya Kanase also involves herself in presenting various articles and attending events in and around Pune to educate people about cataract.

Modern cataract surgery aims to achieve a better unaided visual acuity with rapid post surgical recovery and minimal surgery related complications. Early visual rehabilitation, better unaided visual acuity and surgical safety can be achieved in a great measure by reducing the incision size. Incision size depends on the mode of nucleus delivery and the type of intraocular lens used. It is about 10-12 mm in standard extracapsular surgery, about 5.5 mm to 7.0 mm in manual small incision surgery and 3 mm to 5.5 mm in instrumental phacoemulsification, depending upon the technique and implant. The advantages associated with the smaller incision have made phacoemulsification the ideal technique for cataract surgery and the preferred one where the resources are available.

However, this technique cannot be employed as the standard procedure in developing countries due to certain reasons. Manual small incision cataract surgery offers similar advantages with the merits of wider applicability, better safety, a shorter learning curve and lower cost. Phacoemulsification requires expensive instrumentation which may not be available at all centres, whereas manual SICS requires only a minimum addition to the standard cataract surgery instrument armamentarium. Case selection is very important for an average surgeon doing phacoemulsification, and duration of surgery and incidence of intraoperative complications varies with the nucleus density.

Certain cataracts, like hyper mature Morgagnian or traumatic cataracts are difficult to handle with phacoemulsification. Manual SICS can be performed in almost all types of cataracts and time spent on nucleus delivery does not vary with the cataract. Capsulorrhexis is mandatory for phacoemulsification, whereas manual SICS can be comfortably done with the can-opener or the envelope capsulotomy skills acquired previously. Published data shows that intraoperative complications like posterior capsule rupture are more common in phacoemulsification as compared to manual SICS. Endothelial loss in phacoemulsification depends on the density of the nucleus, whereas in manual SICS, the skill of the surgeon plays an important role.

The final visual acuity has been observed to be similar after both techniques. Phacoemulsification depends upon the machine and machine failure can have serious consequences during a procedure. In SICS, however, the surgical skill and experience of the surgeon play a significant role in the results. Another advantage of manual SICS over other methods of cataract surgery is the shorter duration taken, making it particularly applicable to high volume cataract surgery. If both eyes have cataracts and surgery is agreed upon, the surgery on the second eye is generally planned at least a week after the first eye. There is usually no harm in waiting a much longer period of time between the two eye operations.

At Apex Eye Care Clinic, Dr. Pradnya Kanase (Ophthalmologist and Phacosurgeon) believes in making patients and relatives understand the benefits and risks of surgery, so that he/she can make an informed decision about whether cataract surgery is right.

Apex Eye Care Clinic (Baner, Pune) is well equipped with the latest equipment to cater patients’ needs. Dr. Pradnya Kanase has also ensured that the environment remains clean and sterile.