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Suggest the type of lenses to be preferred for cataract surgery

Answered by
Dr.
Dr. Dadapeer K

Ophthalmologist

Practicing since :2003

Answered : 5709 Questions

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Posted on Fri, 16 May 2014 in Vision and Eye Disorders
Question: Hi,
My aunt is around 65 years old. She is looking to get a cataract operation done in her one eye as prescribed by an eye specialist. However my confusion lies in the type of lens that is to be used and the basic difference between them. I have shortlisted the below mentioned lenses from the available packages and needs information around which one to be preferred.
1) Acrylic Foldable
Lens from an Indian manufacturer will be used
Package cost INR 14,000/-

2) Hydrophobic Acrylic
Lens from an Indian manufacturer will be used
Package Cost INR 19,000/-

3) Akreos (Regular,Hydrophillic)
Lens from Baush & Lomb, USA
Package Cost INR 17,000/-

4) Akreos AO (Regular,Aspheric, Hydrophillic)
Lens from Baush & Lomb, USA
Package Cost INR 21,000/-

I need to understand that which one is better in an Indian Made or an imported one. Also which should lens should i opt for and the basic difference among above mentioned lenses.
Note:- Package cost include the complete surgery cost.
doctor
Answered by Dr. Dadapeer K 1 hour later
Brief Answer:
I advice you to go with Akreos regular or aspheric

Detailed Answer:
Hello
Welcome to Health care Magic

Iam Dr. DADAPEER K, an ophthalmologist and I answer health problems related to eye.

I went through the history and it seems your aunt is 65 years old, non diabetic with cataract and she requires cataract surgery.
Since she is not having diabetes and any other systemic or eye problem she will have good post operative vision and she is fit for implantation of all the different types of intraocular lens (IOL). In diabetic patients we should avoid use of silicone intraocular lenses.


Now coming to your question, regarding the superiority of the different types of IOL.
IOL's are basically made of two different types of material, rigid IOL are made of poly methyl methacrylate whereas foldable IOL's are made of acrylic or silicone.

The foldable IOL's are used following phacoemulsification which is the recent and safest surgery for cataract. Since she is undergoing phacoemulsification she requires foldable IOL's.

You have mentioned here all different types of acrylic foldable IOL's.
The hydrophobic IOL's and hydrophilic IOL's are almost similar in their post operative results.
The advantage of the hydrophobic IOL's over hydrophilic IOL's is less incidence of post operative opacification of the posterior capsule called as after cataract.
The advantage of hydrophilic IOL's over hydrophobic IOL's is excellent biocompatibility and decrease in the inflammation induced by surgery as they are softer than the hydrophobic IOL.

Hence hydrophilic IOL's are preferred over hydrophobic IOL's and I also prefer to use hydrophilic IOL's over hydrophobic.

The aspheric IOL are better and the recent ones and they offer superior visual acuity because of improvement in contrast sensitivity. If affordable the aspherical IOL's are the best one or she can go for hydrophilic IOL Regular.

Hence I advice you to go for hydrophilic IOL either Regular or Aspherical. (option 3 or 4)

The imported one from Bausch and Lomb are superior to Indian made and I advice you to go for Akreos hydrophilic regular or Akreos hydrophilic aspherical.(option 3 or 4)

Hope I have answered your question and the information is helpful to you.

Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dadapeer K 1 hour later
Thanks Doctor for the detailed answer. However i would like to know if we choose option 3 Akreos (Regular,Hydrophillic) over option 4, then will it be fine and my aunt will have no problem in her vision?
We are looking to go for option 3 and therefore just wanted to confirm there will not be any drawbacks/ less clarity in vision as compared to option 4.
doctor
Answered by Dr. Dadapeer K 1 hour later
Brief Answer:
You can go ahead with option 3.

Detailed Answer:
Hello
Welcome to Health care Magic
Thank you for the follow up.

You can go ahead with the Akreos Regular,Hydrophillic IOL, they have been used for so many years and they have given very good results. No need to worry.
The only difference between the regular and aspherical IOL's is the surface of the lens is uniformaly curved in regular IOL whereas it is of varied curvature in aspherical IOL. Otherwise all other parameters including the lens material and manufacturer are same only.
Usually the aspherical IOL's are commonly indicated in young patients with age less than 50 years and after 60 years of age this will not matter much, hence you can go ahead with the option 3.

IOL 's are one of the factors which will affect the post operative vision. The other factors are surgeon, preexisting diseases of the eye... Cataract surgery has become one of the safest surgery as a result of rapid innovations in the medical field.
Since she is not having any other eye diseases or systemic disease, she will definitely have good vision following surgery.

Hope I have answered your question and the information is helpful to you.

Thank you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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