Most developing countries
are now challenged with the problem of blinding cataractous lens disease. India with its large
population has perhaps the largest blind and potentially blind population in the
world. About 80% of this blindness is due to cataract which can be easily cured
by modern eye surgery.Other lens diseases like Glaucomatous lens disease may also lead to irreversible blindness. Dysfunctional lenses lead to focussing errors like presbyopia and loss of reading ability. Dysmorphic lens disease with abnormal shapes leads to cone shaped lenses called lenticonus and affects vision.
Due to many myths and
misconceptions they continue to remain needlessly blind. The social and
financial hardships created by blindness gravely affect individuals and families
in particular and the nation at large.
Poor Vision or Blindness
can be a devastating experience which can change every aspect of the involved
family's life. Many people suffer visual impairment silently and feel isolated
leading to depression, social withdrawal giving rise to many myths and
misconception.
We do hope that exploring
these misconceptions will help you to understand cataract lens removal and replacement surgery, costs,
complications, recovery time and cope up with your problem
slightly better.
Commonly asked questions include
-What are cataracts or motibindu,
-What are the symptoms,
-How do cataracts affect Vision,
-How do they remove a lens,
-What is the cause of Cataractous lens, and
-Can cataractous lens lead to Blindness.
-Other questions include queries related to lens removal and replacement surgery cost such as
whether it is covered under insurance cashless facility, medicare, How much is
the lens removal and replacement operation cost in India or in Bangalore, ( Bengaluru) the price
list for cataract surgery,lens disease types, cataract surgery recovery time,
cataract surgery side effects, cataract surgery complications, cataract surgery
steps, and types of cataract surgery. We hope that your questions will be
answered and your doubts cleared as you read further about the various myths and
misconceptions regarding lens removal and replacement surgery.
1. Regarding Lens removal by Phacoemulsification and Intraocular lens (IOL) replacement Surgery:
Myth: Can I
avoid surgery since I’m already very old? Fact :Unoperated
Cataracts or diseased lenses like lenticonus, lentiglobus, glaucomatous lens in hyperopic eyes lead to complications such as hypermature cataract and lens-induced
glaucoma which may lead to irrecoverable Blindness.
Myth: Is there
any eye drop to cure cataract? Fact: No.
Don’t spend money in buying expensive ‘anticataract’ eye drops or tablets, which claim to
be effective. They are useless and completely ineffective. On the other hand, they contain steroids in some hidden form and lead to localized and systemic immunosuppression leading to opportunistic infections like Candidiasis and Black fungus. Diseases of the lens like opaqueness, loss of transparency, loss of function, loss of shape and abnormal size cannot be treated with medicines.The only effective treatment world wide is surgery and
Phacoemulsification is the most sophisticated form of diseased lens or cataract surgery.
Myth: Can I
wait until next winter for my surgery? I believe wound healing is better in the
winter season?
Fact: There is no seasonal difference in the success of surgery. Waiting till
the next winter will further harden and advance the lens disease while causing more vision
loss and handicap as well as more
difficulty in its removal by phacoemulsification. Besides, Further deterioration
of vision will alter your ability to legally drive independently without a high
degree of risk, it will also create additional complications like Phacomorphic
Glaucoma, Weaker Zonules, Thinner capsules, and senile miosis altering the
success rates of routine cataract surgery.
Soft Cataract- Bloodless, painless, stichless
removal possible by phacoemulsifcation with a very small incision**Benefits to
the patient in the form of enhanced comfort, safety, and satisfaction.
HARD Cataract-
Bigger
incision,
more injury, requires
manual surgery &/or stitches, painful , longer recovery period(6wks) and more
chances of complications.**
FREQUENTLY ASKED QUESTIONS
FAQ: Can I expect clear vision after
surgery? Lens Surgery at Sri
Venkateswara Nethralaya has a very high Success rate since we only perform
Phacoemulsification as the 1st Procedure of Choice.. In advanced
Cataracts and other lens diseases or in cases where manual Surgery is required and performed, Prior
intimation and discussion with the patient as to the maximum vision that can be
achieved in a particular case is conducted along with the family members so
that all your doubts are cleared before you decide on surgery and your
expectations are proportionate to thevisual prognosis of your
condition. We aim to be the
best eye hospital in bengaluru or bangalore for people to undergo cataract
surgery in terms of cost, results, experience, expectations and quality of care.
Patient reviews and feedback are very important to us and we make a detailed
effort to understand each patients needs and concerns so that every patient gets
the best outcomes in terms of quality of care.
Sri Venkateshwara Nethralaya, Rajarajeshwarinagar,
Bangalore is a top,
leading eye care hospital in India providing comprehensive eye care services
including Lasik laser treatment, Phacoemulsification Cataract surgery,
Multifocal IOL implantation, Diabetic Eye Disease treatment, Vitreoretinal
Surgery, Squint Treatment, Oculoplasty, Glaucoma Evaluation and Treatment and
Corneal Surgery and we aim at making it the best eye hospital chain in Asia by
2030. Our Eye Specialists and Consultants in practice are highly experienced and
trained at premier eye institutes such as AIIMS and have over 18 years of
surgical experience.
2. Regarding IOLs :
FAQ: Why should I go for this newer
Intra Ocular Lens (IOL)?
There
are different types of intraocular lenses manufactured today. The foldable lenses
that are used for small incision surgery like phacoemulsification tend to be
more expensive than the rigid one that are usually made from PMMA. The pricing
varies because
of
1. the material used to make the lens
(hydrophilic/Hydrophobic-Acrylic/silicon/collamer) as well as certain special
features that the lens manufacturer puts in such as
a)Square edge design
to delay/prevent recurrent "after cataract" formation with loss of vision after a few months which may require the resurgery again and again. Resurgery can be avoided if a good quality lens us implanted. Even if "After Cataract" formation occurs inspite of a good lens, it does not require surgery as it can be dissolved by a simple OPD laser procedure called YAG laser Capsulotomy.
b)UV light
filters to protect against harmful UVrays( implicated in uveal melanomas/ocular
cancer),
c)Yellow chromophore(blue light filters)
to protect the retina especially the macula and delay the onset of ARMD( Age
related Macular Degeneration- The No 1 cause of irreversible blindness in
patients over 60years),
d)
Wave front technology(Prolate
anterior surface) to compensate for spherical abberration,
e)High abbe value to decrease chromatic aberration,
f)
Refractive index optimization
to decrease negative dysphotopsia and
anti glare technology.
Having a good quality lens implanted in
your eye does make a difference as this lens will serve you the rest of your
life. Your surgeon will be able to advice you on the different type of lenses available.The
advantages of
Monofocal Foldable IOL implantation include faster recovery and a pain free post
operative period. The Comfort levels enjoyed by these patients are much higher
as compared to conventional lenses. With Zeiss Aberration corrected IOLs
patients enjoy enhanced contrast sensitivity and improved night Vision. With Newer generation Multifocal Intraocular lenses your
dependence on spectacles for day to day tasks will decrease allowing you to see
reasonably well for both near and distance. However Not everyone is a candidate
for the newer Multifocal lenses and your eye surgeon will determine which lens is best
suited for you depending on the general health of the eye.
Besides Multifocal IOLs, the latest advancements have been Accomodating
IOLs (Crystalens from Bausch & Lomb) which further refine the quality of vision
achieved post lens disease surgery. We also perform implantation of these
lenses and for a detailed information on this, please
click here.
FAQ: How long will the IOL last in my
eye? Life long.
FAQ: Is it necessary to change the IOL
again? No.
FAQ: Will the IOL get displaced if I
do a lot of physical labour? No, It is implanted inside the
eye and Locked into position inside the Capsular bag after which the IOL gets
fixed into its position permanently.
FAQ: Will it cause irritation inside
my eye? No.
FAQ: Do I need to wear spectacles
after IOL implantation? Most
patients do not require glasses after surgery for their distant vision,
However,reading spectacles will be required for near and intermediate vision if only monofocal
lenses are implanted. It also depends on your personal needs and occupation.
If Multifocal IOLs are implanted, your dependence on glasses will be vastly
reduced for both near and distance visual tasks. 90% of your visual needs can be acheived without glasses except for reading very small or fine print or for activities like threading a needle. Newspaper, Magazines etc reading can be achieved without glasses.
FAQ: How Successful is Lens
surgery by Phacoemulsification?
Lens Surgery by Phacoemulsification is considered to be a modern medical miracle and a marvel of Advanced Medical Technology.
Todays lens surgery by Phacoemulsification for cataract and other lens diseases is blood less, stichless,
painless, and is performed in less than 20-25 minutes, and the patient is ready
to go home after about 2-3 hrs stay in the hospital.
This surgery is very successful in restoring vision — more than 99.9 percent of
people who have a diseased lens removed have no complications and end up with clear
and superior vision. Most people report not only better vision but also a
drastic reduction in the power of their lens prescription enabling spectacle
free life leading to highly appreciated improvements in their overall quality of
life after the operation.The difference in vision before and after cataract surgery is not only
in terms of sharp and clearer Vision, but also brightness, contrast, colour
perception, nighttime vision also dramatically improve leading to a rich and
rewarding experience for
both the patient and the Eye Surgeon. To the patient, its a once in a
lifetime opportunity to start seeing nice and clear once again and to the eye
surgeon, its a once in a life time chance to be a part of a miracle in his
patients life.. No wonder one can see more and more medical students take up
Ophthalmology to specialize in as it offers a good work-Life-Compensation
balance with enormous and never ending professional pride and satisfaction.
Approximately 9 million Indians are blind from cataract with
another 1.8–3.8 million going blind from cataract and other lens diseases every year. Worldwide over
37million people are blind due to cataract diseased lens and is the No1 cause of reversible
blindness.
More than 7
million lens replacement operations are performed each year in India alone. To
Know what our patients have to say about these procedures,
click here. To know more
about the inventor of Phacoemulsification Charles D. Kelman, Please
click here
FAQ:
When do I have to undergo the procedure?
As early as possible. The longer
you wait, the lens disease not only continues to worsen and become more opaque
leading to further loss of vision, but it also may thicken further leading to
increased intraocular pressure and finally irreversible blindness in the form of
glaucoma. It will also harden further to the point where easy automated removal
may not be possible and manual surgery requiring a large incision and stitches
may have to be performed. The longer you wait, more difficult it becomes to predict the outcome of surgery since
it blocks the view of the retina, which is required to estimate post operative
visual recovery. This is the reason why some patients with advanced cataracts
who have delayed surgery against medical advice
fail to recover completely as advanced cataract lens disease are more harder and it
becomes more difficult to remove. An older person who needs to be independent in
performing his day to day activities progressively isn't very active and is
dependent on others for his day to day activities such as
1.Guiding oneself to the
bathroom,
2.taking medicines,
reading prescriptions and drug information,
3.driving smoothly,
accurately visualizing humps and potholes and estimating the distance by braking
smoothly and accurately,
4.signing cheques,
identifying numbers in the cell phone, or performing tasks like reading notice
boards and calendars.
Some elderly patients may
be terminally ill & bedridden & may
have less need for sharp vision than a patient in the working age group who
needs to drive a car and be independent in his day to day activities .
These group of patients may delay surgery to the point where they are totally
blind as their anticipated lifespan is short (days/weeks). However, This
misleads
many old healthy patients to think that surgery can be delayed till complete blindness
ensues, but unfortunately such misadventures may lead to blindness even with
successful surgery performed at a late stage with other comorbid complications.
Also the success rates of cataract removal with phacoemulsification are different in different surgical hands
in different stages and leads to
unsatisfactory results in some cases when performed in the last stage. So YOUNG, MIDDLE AGED, or OLD,
the treatment has to be AS EARLY AS POSSIBLE.
People with only minor
vision loss from a cataract will require surgery because of problems with glare
or double vision. Sometimes a cataract should be removed even if it doesn't
cause problems with vision — for example, if it's preventing the treatment of
another vision threatening eye problem, such as Age-Related Macular
Degeneration , Diabetic Retinopathy or Retinal detachment.
FAQ: What are the risks of not having
cataract or lens disease surgery?
If you choose not to
have cataract or lens disease surgery,
the lens condition and its effect on your vision will most likely continue to further
worsen. This may
affect your ability to do your everyday activities independently and drive
safely, especially at night. Vision problems may lead to falls, accidents, and
injuries. Your dependence on family
members for even minor tasks such as reading the MRP of a product, reading drug
information, signing Cheques will continue to increase leading to lifestyle
changes and social withdrawal.
All Lens diseases including Cataract has a higher
risk of complications if they advance to a stage where it becomes hard
and may burst open inside the eye. This causes a very painful condition
called Phacomorphic Glaucoma which leads to irreversible loss of vision even
with modern eye surgery. In the United States and in other countries whenever
diseased lenses are removed in the early soft stage by phacoemulsification, cataracts
rarely cause blindness. TodaspaLens removal and replacement Surgery as practiced in Sri Venkateswara Nethralaya is
a stichless, bloodless, painless procedure performed in less than 20mins
and the patient is sent home immediately after surgery and no hospitalization is required.
Benefits of early surgery include restoration of maximum vision without glasses,
return to normal activity the next day itself and minimum or no complications
whatsoever leading to a happy surgeon and a more happy patient.
FAQ: Since
Cataract and lens disease surgery is permitted under insurance CASHLESS claim, can i avail
cashless facility for this illness ?
All insurance companies provide two forms of claim facility
A) CASHLESS B) MEDICAL
REIMBURSEMENT
We encourage all our patients to
pay the hospital charges upfront, take the bills
which will be provided by us along with the signed claim form and lodge their
claim for Medical reimbursement which is usually settled
by most reputed insurers within 15 days. This ensures that the insurer is
not able to modify the treatment plan of the doctor/hospital and the best care,
treatment, implants and consumables will be made available to the patient as
discussed preoperatively with him/her.
However, if the patient avails CASHLESS
facility, it gives an opportunity to the insurer to force
the hospital to downgrade the treatment plan from the backend as per preagreed
tariff with the hospital to the lowest possible package so that the
insurer maintains his profitability and does not have to pay the hospital higher
package rates demanded by the patient. Please remember
that even insurers are a part of this system for earning their profits and they
are not ANGELS. Insurers also want hospitals to do this discreetly
without raising any alarm bells in the patients mind.
This puts the doctor/hospital managements
in a difficult position as they have to look at a long term relationship with
the insurer for sending patients and cannot afford to say "NO" to them,
Most patients however do not understand
why the best or costlier treatment packages have been denied to them under
cashless as they are under the impression that the insurer is obliged to provide
the best facility to everyone irrespective of their backgrounds and refuse to
accept downgraded packages preoperatively.
However, As we said before, Insurers are
not angels and it is their opinion that if the patient
wants the best for himself or herself, let them pay for it upfront and claim
reimbursement as then, patients will do some due diligence by and for themselves
and pay up as per their paying capacity. There is also a strong chance
that the patient may not choose higher costlier packages if he/she is asked to
pay upfront and claim reimbursement later. All this
translates into higher profitability to the insurer which ensures their
survival.
But if everyone is provided the best
under CASHLESS facility, then insurance cos will have to run their business at a
huge loss which is detrimental to their survival as they cannot raise premiums
beyond a certain level.
So, many hospitals
when squeezed from both sides (patient and insurer) decide internally to
compromise on their own without informing patients by using, reusing & sharing
consumables as well as using cheaper implants to cut costs so that the insurers
interest are kept foremost and the best surgery is also seemed to have been
"done". However, problems occur when the expected results are not
accomplished and doctors have to explain post operatively on the specifics when
things are questioned, investigated and discovered by the patient later. This
creates a lot of negative animosity against the treating team and the
insurer who was responsible for all this is now neatly firewalled & safeguarded
as he is not responsible for the results. The patient is
the final loser in this system as he realizes that under CASHLESS system, he has
the least voice as it was actually a trap to get him/her to undergo a less than
ideal procedure meant for the voiceless, poorest of the poor who usually
fall into such lure and traps of "CASHLESS" facility or free healthcare.
Hence, we strongly urge patients to get
treated first paying upfront, having a one to one relationship with his/her
doctor and hospital and then claim for reimbursement with their insurer on a one
to one basis who then has to settle the dues as per the agreed policy terms with
the policy holder. This minimizes any scope for the insurer to play in the
backend any games that puts the treatment and outcomes at risk. The hospital
will provide all relevant documentation, bills, receipts, as well as proof of
consumables and implants used in the patient so that the patient does not have
any difficulty in claiming reimbursement. Millions of patients who understand
the healthcare system in India use this method to avail the best care for
themselves and the satisfaction rates achieved by the patient is much higher as
compared to the CASHLESS facility.
FAQ: Are all
insurers like this or are there some insurers who are considerate and
compassionate?
Definitely no, There are some insurance companies which are considerate and
compassionate and have a sense of their social responsibility. We have
appreciated their honesty and we have approved them for cashless facility at our
hospital. You can enquire about the approval for cashless
facility of your insurance provider with us at the time of the initial
consultation. If we have approved them, we will offer you cashless
facility. However, if we have not approved them for
cashless facility, we strongly urge you to utilize the medical reimbursement
facility wherein you can pay upfront at any registered hospital in India and
claim settlement from your insurer later within a period of 15 days.
FAQ: What is the
cost of Lens removal and replacement Surgery for various lens diseases like cataract, glaucomatous lens, etc at your Hospital?
The cost of lens removal by Phacoemulsification and IOL implantation Surgery by
Phacoemulsification varies according to the type of Intra Ocular Lens Implanted
inside the eye.
The preoperative investigation charges,
Anaesthesia Charges, Post Operative Medicines, and Glasses will be charged extra
and will be as per actuals.
Some patients may require additional
procedures like Limbal Relaxing Incisions, Astigmatic Keratotomy, Pterygium
Surgery, MMC Application, Conjunctival Grafting, Glaucoma Surgery, or special lenses called Toric lenses along
with Cataract/Diseased lens surgery. Such patients will be charged additionally for the
associated procedure and the additional cost will be communicated on a case by case basis.
All packages are on a single eye basis as
one eye only is done at a time. If both eyes are to be done, package rates will
be double as mentioned above.
In some cases, where cataract surgery by
phacoemulsification cannot be done due to advanced stage, preoperative
discussion on the achievable results will be conducted and Manual surgery may be
done. The cost of manual surgery will be lesser than phacoemulsification and
such calculated cost will be communicated to the patient on a case by case
basis.
FAQ: How much
reimbursement can be expected in an average policy issued to the policy holder
The normal reimbursement rates are around 20% of the total sum assured. This
means that if the insurer has issued to you a policy for 1 Lakh, You are
eligible to claim around Rs 20000/- per eye. However nowadays most
insurers have a upper limit capping of claims for cataract surgery pegged
at Rs 25000/-. This means that if you are insured for 5 Lakhs also, you can
claim only Rs 25000/- maximum instead of Rs 1,00,000/- as was previously the
case. Hence Most patients spending more than 25000/- per eye, will have to be
prepared to partly contribute to their surgery to the extent of Rs 5000-10000
per eye.
Soft Cataract- Bloodless, painless, stichless
removal possible by phacoemulsifcation with a very small incision**Benefits to
the patient in the form of enhanced comfort, safety, and satisfaction.
HARD Cataract-
Bigger
incision,
more injury, requires
manual surgery &/or stitches, painful , longer recovery period(6wks) and more
chances of complications.**
VENKATESWARA
NETHRALAYA