A hi-tech laser that makes cataract surgery foolproof is all set to revolutionise treatment of the disease that is the leading cause of blindness in India. The catch is that the cost of the new procedure is well over double that of the existing stitchless cataract surgery.
Cataract is the blurring of vision because of clouding of the eye’s natural lens, which is the part that focuses light on to the retina to form an image. It is usually age-related, and if left untreated, eventually leads to blindness.
Conventional treatment involves surgically removing the cloudy lens and replacing it with an artificial lens inside the eye. The no-stitch technique — called phacoemulsification — involves a small ultrasonic probe being inserted into the eye through an incision that is less than 2.2 mm. Next, high-frequency ultrasound waves are used to fragment the cataract, which is then washed out from the eye.
An artificial lens is inserted inside the eye. No stitches are used and the incision is self healing, with the patient going home the same day.
The new computer-guided femtosecond laser is the next step to dissolving cataracts. The surgery is bladeless and uses a machine called an optical coherence tomographer (OCT) to create a detailed three-dimensional image of the inside of the eye. “This helps the surgeon plan, customise and perform the entire procedure with precision unmatched by human hands,” says Dr Sanjay Chaudhary, managing director, Eye7 group of eye hospitals, where 40 cataract surgeries have been done using the femtosecond laser.
Once the data is fed into the machine, femtosecond laser cuts the tissue, which is traditionally done using a knife. “This technique improves the skill of the surgeon and completely eliminates human error,” he adds.
Dr Mahipal Singh Sachdev chairman and medical director of the Centre for Sight Group of Eye Hospitals, chooses to put it less dramatically. “Since all the critical steps are done using computer-controlled laser, the final placement of the new-generation accommodative or toric lenses that eliminate the need for refractive glasses is perfect,” says Dr Sachdev, who is acquiring a femtosecond-laser this fortnight.
The catch is the price, which is more than double of conventional surgery.
While conventional cataract surgery (phacoemulsification) costs Rs 40,000 for each eye, the new bladeless surgery costs Rs 85,000 to Rs 1.2 lakh, depending on where you go. Since it’s a step towards perfect post-op vision, there are likely to be more than a few takers for the surgery, irrespective of cost.