Sandeep Aggarwal, a 45-year-old government officer in Lucknow, took a couple of hours off from work, walked into a neighbourhood eye hospital, had his cataract removed and went back to work.

Gone are the days when cataract surgery meant taking a fortnight’s leave, wearing those typical dark glasses and having to go without a head bath for two weeks.

Cataract surgery has never been more convenient, painless, safe and fast, thanks to a new technique called Co-axial Micro Incision Cataract Surgery (C-MICS), simply called MICS.

A cataract is basically the clouding of the crystalline lens of the eyes. This obstructs the passage of light beyond the lens and focusing on the retina, thus dimming vision. Cataracts usually occur in the elderly. They progress slowly to cause vision loss and can be potentially blinding if left untreated.

Phaco-emulsification, the microsurgical process commonly used for cataract removal, requires an incision of 3.2mm in the cornea. Now, with state-of-the-art equipment called Stellaris Vision Enhancement System from Bausch & Lomb — launched simultaneously in October 2007 in the US, Europe and Asia (India) — the incision has been reduced to 1.6mm-1.8mm. The new process involves MICS with the implantation of a 3rd generation intra-ocular lens (IOL) using the Stellaris.

With 10 machines being installed in India so far, the method appears to be catching the fancy of people.

Dr Mohan Rajan, chairman and medical director of Rajan Eye Care Hospital in Chennai, ruled out the possibility of any injury during the insertion of the lens through such a small aperture. This is because of the special injector system for the Akreos Advanced Optics Micro Incision Lens (Akreos AO MIL), a zero-aberration, ultra thin foldable IOL. With over 700 surgeries to his credit, there is perhaps little room for doubt.

The 50 per cent reduction in the incision size makes healing and recovery faster, confirm leading ophthalmologists. The possibility of infection, too, is low, thanks to the quick healing and all consumer items being disposable. The need for follow-up visits to the surgeon is also reduced. Moreover, a smaller incision ensures less astigmatism (a refractive error in which parallel rays of light from a source do not converge on a single focal point on the retina) and less requirement of post-operative spectacles. Faster healing is definitely a boon for diabetics.

Vision recovery being nearly instantaneous, “the patient can resume his or her daily activities almost immediately and bathe within 24-48 hours,” assures Dr Rajesh Bhatia, medical director of Chandra Mother Eye Care and Laser Centre in Lucknow, where Aggarwal underwent surgery. Using the Stellaris he has conducted over 600 surgeries till date. “Apart from the convenience, the lens offers 20 per cent better eyesight and glare free vision at night. It also protects against ultraviolet rays,” he told Knowhow.

The Stellaris Vision Enhancement System from Bausch & Lomb

“It is a nice machine with very good ultra sound modulation but is not something to go gaga about,” opines Dr Debasish Bhattacharya, chairman of Disha Eye Hospital & Research Centre in Barrackpore, which recently witnessed the first demonstration of the Stellaris in eastern India. “It is a third generation equipment just like the Infinity we use. The limitation we have is with the AcrySof lens that cannot be inserted through such small incisions. The latest Akreos lens resolves that.” But as of now, he prefers the former because “it is more time tested and I shall not experiment with my patients’ eyes.” He goes on to rue that LASIK, the most preferred laser vision corrective procedure in the US, has not gained favour in India. His anguish arises from the fact that the person behind this technology is an Indian, Dr Mani Lal Bhaumick.

Dr Samar Basak, director of Disha and a special invitee to a live surgery (MICS) in Croatia in May 2008, too, says that he prefers the older lenses as they have withstood the test of time. Agreeing with Dr Bhattacharya on the instrument, he refused to comment on the new lens as “it is too early for that”. “Honestly, for a 70-75-year-old patient I might not be very particular. But for a 55-year-old I’ll surely use a lens that will last him long-term — say, around 20 years — and it won’t be the Akreos,” he concludes.