DIVA Eye Institute provides complete eye care under one roof. Dr Dipan Desai is the Pioneer of phacoemulsification in INDIA. He started phacoemulsification in INDIA in 1987. He had imported the first phaco machine from WILMER EYE INSTITUTE, John Hopkins , Baltimore, USA. He has taught this procedure all over the country and has many innovations to his name. He has gone through the all difficulties and has been privileged to experience all the advances related to this surgery.
DIVA Eye Institute is one of the centers in the western India which facilitates cataract extraction through smallest incision and gives the options of all the Intra Ocular Lenses of your choice available in the world
Cataract is caused by clouding of this natural lens of the eye (Fig.2). This clouding obstructs the passage of light, resulting in blurring of the vision (Fig.3). Hence routine activities such as reading, driving, etc, become difficult. Cataracts are not contagious and do not cause cancer.
Cataract is one of the major causes of blindness in the world. It is an eminently treatable condition and full restoration of sight is possible after surgery.
- Painless blurring of vision
- Frequent change of glasses
- Glare and haloes seen around light source
- Poor night vision
- Difficulty in appreciating colour shades
Congenital Cataract : Sometimes a child is born with cataract in the eyes. A common cause for this is ante-natal TORCH infection.
Traumatic Cataract : A blunt or penetrating injury to the eye may lead to cataract formation.
Patients with a history of long-term steroid medication, kidney disease, thyroid disorders or diabetes are more prone to developing cataracts.
Your eye surgeon will recommend removal of the cataractous lens if it is interfering with your daily routine and activities. The only way to deal with cataract is surgical removal. It cannot be removed by laser, medications or drops.
During surgery, as a routine, an intra-ocular lens (IOL) is implanted in place of the cloudy lens. Precise measurement for the IOL power can be taken by two methods: (1) Ultrasonic Biometry (2) IOL Master (Laser). You will then be given an appointment for surgery.
The only treatment available for cataract is surgery. Modern surgery involves removing the cataractous (cloudy) lens. An artificial Intra Ocular lens (IOL) is then implanted in its place. This lens is permanent and provides natural vision.
Cataract Surgery is amongst the most commonly performed surgeries all over the world. Millions of patients have been operated till date. In the older methods, cataract surgery required a cut in the eye 10-12mm wide which required stitches. This resulted in a number of restrictions after the surgery.
1. Manual Small incision Cataract Surgery (SICS)
- Requires a smaller incision of 6mm.
- The cataract is removed manually and a foldable intraocular lens (IOL) is implanted
- No stitches
- Heals fast
2. PHACOEMULSIFICATIONWith phacoemulsification and implantation of foldable intraocular lens (IOL), the treatment of cataract has become very sophisticated yet simple. The procedure is safe, accurate and leads to rapid recovery. Thus, phacoemulsification with foldable lens implant is the most recommended treatment for cataract.
We perform most cases under topical anaesthesia (only anaesthetic drops). A very small (1.8mm.) incision is made through which a thin phako probe is inserted into the eye. This probe, with the help of ultrasonic energy, breaks the cloudy lens into small fragments. These are further emulsified and then aspirated through the same probe. An artificial foldable intraocular lens is now inserted through the same small incision. No sutures need to be taken and the eye does not need to be patched. The whole produce approximately lasts about 10-12 minutes .
You can go home half an hour after surgery and can resume normal activities such as reading and watching television on the same day. Thus this is a no stitch, no pad, no injection surgery! Visual rehabilitation is also much earlier than with conventional cataract surgery. Phako emulsification is the current popular trend for cataract surgery worldwide. With it, cataract surgery has become simple, comfortable and safe.
At DIVA, we use some of the most advanced and expensive phako-emulsification systems in the world - the Stellaris Vision Enhancement System (SMICS), Sovereign White Star technology (Cold Phako), Millenium Phako system,and Oertli Phako machine. These allow us to remove the cataract through the smallest incision, thus giving least trauma and fastest visual rehabilitation.
ADVANTAGES of PHAKOEMULSIFICATION over other Cataract removal Surgeries
- In most cases this surgery can be performed without giving any painful injections around the eye. Anesthesia is achieved by using eye drops only.
- "NO INJECTIONS, NO STITCH, NO BANDAGE SURGERY"
- This surgery also minimizes the need for spectacles after surgery due to lesser induced cylindrical power
- The procedure is safe and is ideal for diabetic patients. It can be performed in any season.
- The visual recovery often starts within a few minutes and is complete in a day or two as compared to traditional surgery where the total visual recovery is acheived in 6-8 weeks
- This is called a "WALK IN WALK OUT" surgery. The patient can go back home without any bandages or an eye pad within half an hour of surgery and can resume most of the daily routine activities like watching TV, bathing driving, cooking etc. the same day without any significant restrictions. The patient can start work from the third post-operative day.
- Foldable lenses are another major breakthrough. They are placed through the same small incision in a folded state, using special lens injectors. This leads to near instantaneous visual recovery and prompt wound healing (DRIVE BACK SURGERY).
- With the advent of the new Aspheric, Toric, Multifocal, Toric Multifocal and Accomodative Intra Ocular Lenses, we can now correct cylindrical numbers and provide Distant, Intermediate and Near Vision without glasses.
- Recently, newer refinements of phakoemulsification - S-MICS (using coaxial-microincision cataract surgery) and B-MICS have been introduced. These have revolutionized the way cataract surgery is being performed. At the DIVA Eye Institute we offer you the options of cataract extraction by S-MICS and B-MICS, considered to be the best options of phacoemulsification in the world. Along with this a wide range of options for Intra Ocular Lens are available, according to your need and choice
Stellaris Phaco Machine
SMICS: Coaxial - micro incision cataract surgery (C-MICS) is performed through a 1.6 mm - 1.8 mm incision, and a third generation, ultra-thin, foldable intra ocular lens called MIL (Micro incision Intra ocular Lens) is implanted. This revolutionary technique of cataract removal is done using the most advanced cataract removal system in the world - the "THE STELLARIS VISION ENHANCEMENT SYSTEM".
Extremely high quality surgery has been made possible with this new technique, called Stellaris-Micro Incision Cataract surgery (S-MICS). It is one of the most advanced cataract removal systems on the planet. It allows us to use the least amount of ultrasonic energy in the eye. The heart of the machine has a sensor which takes in important parameters and reacts faster than the human brain to prevent complications.
The technique of S-MICS makes cataract surgery extremely safe, painless, speedy and very accurate. Vision recovery after surgery is near instantaneous - within a matter of minutes. There is no need forpad or bandage after the surgery. The patient may even be able to drive back home and resume the daily routines of life on the same or the next day.
Advantages of S-MICS :S-MICS reduces the incision size by approximately 50% (to 1.6-1.8mm) from the present popular size of 2.8-3.4 mm with standard phacoemulsification (from Keyhole to Pinhole).
The advantages of reducing the incision size are significant:
- Smaller incisions (50% smaller) heal faster and lead to faster vision recovery
- The original shape of eye is changed less with a smaller incision. Hence there is less chance of astigmatism and decreased requirement of post-operative spectacles
- Improved IOLs with advanced optics technology provide enhanced quality of post-operative vision and vision contrast
- Faster healing is good news for diabetic patients with a tendency to delayed wound healing.
- Less incidence of infections (as wound heals fast)
- Minimal restrictions post-operatively (as the wound heals super-fast)
- Less follow-up visits to the surgeon
- The patient can get back to his normal life-style and can watch TV or use the computer almost immediately
- MICS is safe even in summer /rainy season, thus breaking the age old myth about cataract surgery being unsafe at these times
In fact S-MICS along with MIL through a small (1.8mm to 1.6 mm) wound size is the most modern method of the cataract surgery in the world today: the conventional technique of Phaco through a 3 mm incision may be obsolete in future.
More and more cataract patients are getting the benefit of this patient friendly surgery as it leads to better healing and faster recovery.
At Diva Eye Institute, we provide all varieties of intra ocular lenses & are qualified to use them.
We have been pioneers in phacoemulsification and implantation of intra-ocular lenses. Dr Dipan Desai has been instrumental in designing IOL's & delivering devices. (Integrated IOL through smallest incisions)
- Monofocal Non- Foldable IOLs
- Monofocal Foldable IOLs
- Monofocal Aspheric IOLs
- Monofocal Toric IOLs
- Multifocal IOLs
- Toric Multifocal IOLs
- Accomodative IOLs
- Special IOLs for different pathologies of the eye
- Trifocal IOL's
1. Monofocal Non Foldable IOLs (PMMA)These are non-foldable plate lenses made of polymethylmethacrylate and have to be inserted through a minimum incision of 5 mm.
2. Monofocal Foldable IOLsFoldable Intra Ocular Lenses are made of different materials where by one can fold them to decrease their size while inserting the lens through the small incision. There are various types of foldable lenses such as Hydrophilic acrylic , hydrophobic acrylic and silicon.
|Acrylic IOL||Silicone IOL|
3. Monofocal Aspheric IOLs
Monofocal Foldable lenses can be biconvex and aspheric in design. Aspheric foldable IOLs reduce spherical aberration, improve functional vision and improve performance in a night-driving.
A standard monofocal IOL is a fixed lens (it doesn't move). It is designed to deliver improved vision at just one distance (usually far). The potential drawback is that after surgery, you will probably need to wear glasses for near and intermediate vision, even if you didn't wear glasses before surgery.
MIL Akreos AO (microincision lens, model MI 60)
This aspheric foldable IOL is an award winning lens manufactured by Bausch & Lomb (Rochester, NY). The Akreos AO micro-incision lens, model MI60, is an intraocular lens intended to replace the human crystalline lens during cataract surgery. The model MI60 is designed for insertion using advanced sub-2-mm microincision cataract surgery. It is capable of being introduced through a 1.6-1.8 mm incision. Thus it is probably the only truly Zero abberated lens to go through the smallest incision in the world.
The advantages are extremely clear vision with the best possible colour and light contrast and speediest recovery. The surgeons at DIVA have the highest/longest experience of using this lens till date in the country and the Asia-Pacific region.
4. Toric Monofocal IOLsThe corneal curvature may be different in various degrees of axis. One axis meridian may be steeper or flatter than the other. These common irregularities are called "corneal astigmatism". It causes blurred or distorted vision because light rays are not focused at one spot to provide clear vision. It is in these eyes that we have to give cylindrical numbers. Even after implanting an IOL we will have to wear cylindrical glasses after surgery. Toric IOLs are designed to correct the cylindrical power (Astigmatism), also preventing to need wear glasses for distance and providing excellent visual clarity. With the Combined Benefits of Toricity and Asphericity, the Toric IOL truly offers the best of both worlds.
Earlier we had to perform another surgical procedure to correct the corneal astigmatism such as astigmatic keratotomy, limbal relaxing incision, Lasik etc. The Toric IOL alleviates the need for such secondary procedures; minimizing the need of glasses or contact lens for distance vision.
5. Multifocal IOLs
Multifocal IOLs are specifically for patients who do not want to wear glasses. There are three types of visions - distant (44 inches to infinity), intermediate (upto 14 to 44 inches) and near vision (between 14 to16 inches).Multifocal IOLs are used to correct distance and near vision. A multifocal lens uses multiple visual zones that are built into the lens itself to provide vision at various distances. These can be compared to the rings of a target, with some rings being dedicated to distance vision, and others for near vision. The result is similar to having a bifocal or trifocal lens inside the eye. A multifocal IOL projects multiple images, requiring your brain to adjust to the differences. Some patients have difficulty adjusting to seeing this way. Additionally, intermediate vision (at arm's length) can be compromised because the technology is designed mainly for near and distance vision, at the exclusion of intermediate vision. With multifocal IOLs, patients can have potential issues of glare and halos especially when driving at night.
For many who wear glasses or contact lenses the multifocal lens could mean independence from these. The multifocal lens not only treats presbyopia and cataracts, but it also turns back the clock to restore much of your ability to see up close, and at distance, in both bright light and low light situations.
There are distinct benefits with multifocal IOLs of not having to wear or minimizing the ned to wear glasses for distances or at near, but we have to take the following factors into consideration
- When Multifocal IOL is implanted in one eye, the other eye also has to have one implanted as soon as possible to get desired and good results.
- There is a slight decrease in slight contrast sensitivity(theoretically) but it is never noticed by patients
- Due to design of multifocal iol ( having rings) , one sees halos around light at night. But due to phenomenon of neuro adaptation one gets adjusted within a month and usually does not bother.
- There is an additional cost in using multifocal IOLs
- These surgery is not suited to finicky , fussy patients who have lawyer type personalities.
6. Toric Multifocal IOLsToric Multifocal IOLs are used in patients who have corneal astigmatism. These lenses are designed to correct distant, near vision and corneal irregularities (astigmatism).
True performance at all distances, with exceptional Near and Distance vision.
7. Accommodating IOLs
As the name implies, an accommodating lens "flexes" or "accommodates" using the eyes natural muscles to focus on subjects at various distances, delivering a fuller, more natural range of vision. Crystalens is the one and only FDA-approved accommodating lens available in the United States. Many patients hardly if ever wear glasses after surgery. More than twice the number of patients implanted with Crystalens could see at all distances compared to a standard IOL.
9. Trifocal IOLThese are the newer generation multi-focals called – Trifocals. This offers additional benefit of clear, intermediate vision as well as distance in near vision with minimal glare and hallows at night over multifocals. This lens enables patient to switch naturally between distances.
Crystalens not only treats your cataracts (a clouding or hardening of your lens), but can also reduce or eliminate your dependence on glasses. It does so by recreating accommodation similar to your eye's natural lens. The unique Crystalens can reduce or eliminate glasses for most activities, including: reading a book, working on the computer, and driving a car.
Crystalens was modeled after the human eye. Like the natural lens, it uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs, just like a young person's eye.
- The first and only FDA-approved accommodating intraocular lens
- The only FDA-approved intraocular lens that uses the natural focusing ability of the eye
- The only FDA-approved presbyopia correcting IOL for cataract patients that provides a single focal point throughout a continuous range of vision
- Few patients with Crystalens have experienced problems with glare, halos and night vision. Crystalens focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images, requiring your brain to "adjust" to the differences
Provides a Broad Range of Vision: Crystalens moves and changes shape using the eye's natural focusing mechanism, instead of remaining fixed and stationary within the eye. This movement, or accommodation, allows the eye to focus on objects across a broad range of distances to reduce or eliminate dependence on glasses. In particular, this accommodation provides significant advantages in addressing intermediate vision.
Maintains Clarity of Vision: Unlike multifocal lenses, Crystalens directs all available light received by the eye to a single focal point, comparable to that of a healthy natural lens.
Patient Adjustment Not Required: Crystalens produces a single image consistent with normal vision, meaning patients do not need to neuroadapt to viewing multiple images. Patients also do not need to tolerate or adjust to high levels of halos and glare often associated with multifocal IOLs.
1. ANIRIDIA IOLsunique solution for the correction of aniridia as well as iris coloboma. Coloured body and haptics and additional optical correction are available for scleral, sulcus and capsular bag fxation.
2. Scleral Fixation IOLs: These IOLs are for Aphakic eye
Special IOL's for different pathologies of the eye.
Glued IOL - DEI (Diva Eye Instailed) was done pioneers work in glued IOL's.These IOL's are used in complicated situation where the naturas lense in dislocated fallen behind in vitrous etc.
Here insted of the IOL,it is glued and there patient do that have to were double powerd + Glasses (+10.0 D•)