CHANDIGARH, Jan 29 — With latest techniques available, phacoemulsification of white cataract is now possible. Talking to Chandigarh Tribune, during the annual conference of the Chandigarh Ophthalmological Society here yesterday, Dr Jagat Ram, Additional Professor, Ophthalmology Department, PGI, said this technique, to which the world was recently introduced in the year 2000, is now also available in the institute.
Phacoemulsification involves a small incision of 3 mm on cornea. Following ultrasonic emulsification of the cataract, a foldable intraocular lens is implanted.
According to Dr Jagat Ram, in India, 25 per cent of cataract cases, especially from rural areas, come to the hospitals at a very advanced stage.
The conventional techniques of correcting cataract required a big incision, involving 5 to 7 sutures and long stay in hospital. In the phacoemulsification technique, no suture is required and the person becomes mobile the same day.
This technique, however, is best applicable when cataract is noticed at an early stage. The later-stage treatment, besides being difficult for the surgeon, may also not give very good results.
As per Dr Jagat Ram, last year an extension of the phacoemulsification technique was developed whereby dyes called trypan blue or indosynin green are injected into the anterior chamber. This stains the opaque chamber and the white margins of the cataract are clarified, thereby making it possible for the surgeon to visualise the entire process of phacoemulsification. Moreover, clinical studies also reveal that the dye does not have any toxic effect on the patient.
The focus of the one-day symposium was diabetic retinopathy. While Dr B Patnaik from Delhi gave an introduction to the epidemiology and pathology of the disease, Prof Amod Gupta, Head, Ophthalmology Department, PGI, presented the role of vitreous surgery in the condition.
Dr M.R. Dogra, Associate Professor, Ophthalmology Department, PGI, talked about the role of laser surgery in correcting the disease. According to Dr Dogra, diabetic retinopathy is the major emerging cause for blindness in the country with 5 to 8 per cent people in the country suffering from diabetes.
As per Dr Dogra, awareness in both patients and doctors is also important because unlike cataract surgery, treatment for diabetic retinopathy is very expensive. While the earlier stages require a treatment with laser, advanced cases have to be treated with the more complicated vitreous surgery. While cataract surgery is commonly available, laser and vitreous surgeries are expensive and are also not available in most of the health institutions of the country.
A strict control of diabetes has shown that it delays the onset of retinopathy and cuts down its progression, said Dr Dogra. It is a multi-system disorder which affects the blood vessels in the body. In eyes, during the early stages, blood, fats and fluids start leaking. Later this develops into abnormal blood vessels, leading to massive haemorrhage and subsequent blindness.
Dr B. Patnaik, President, Delhi Ophthalmology Society, presented the Grover Memorial Oration on the “Eale’s disease, old disease, new outlook.” As per Dr Patnaik, the disease predominantly affects young males in the age group of 20 to 40. While its causes are not known, it is quite prevalent in India.
Experts attribute the causes for the disorder to the presence of tuberculosis and other numerous infectious diseases in the country. Why it predominantly affects males is not yet known.
As per Dr Ashok Sharma, Associate Professor, Ophthalmology Department, PGI, the patient suffers repeated bleeding along the infectious blood vessels of the retina. The earliest indications include cobwebs or small objects in front of the eyes and later a complete loss of vision.
As per Dr Patnaik, an early detection is important as its management depends on the stage at which the disease has been detected. While the initial stages can be treated with drugs the later stages have to be treated with laser.
Other speakers included Dr S. Sood, Head Ophthalmology, GMCH, Dr S.S. Pandav, Dr Vaishali Gupta, Dr Anil Bhansali, Dr Sashi Kapoor, Dr S.P.S. Grewal, Dr Gagandeep Brar, Dr Subina Narang and Dr Rohit Kapoor.