CATARACT WITH PHACOEMULSIFICATION
Dr. P.C.Sharma Eye Hospital is fully equipped with the most modern technology for performing sutureless cataract surgeries. We have also increased the capacity in our out-patient department with streamlined systems for consultation & investigation.
Cataract is the leading cause of decreased vision and blindness in our country. It can be cured by a simple cataract extraction microsurgery, which, these days is performed using advanced technology in a short time.
We are one of the few Hospitals in the North Zone to have the 4 top platforms for cataract surgery – the Infinity (Alcon), the Laureate (Alcon), the Millennium (Bausch & Lomb) and the Oertli (. All these machines can be used for the latest Micro-Coaxial Cataract Surgery (MICS), or removal of the cataract through a 2mm (or less) incision with the implantation of foldable intraocular lenses (IOLs). We offer our patients the latest in IOL technology including the accommodative Crystalens HD, the ReSTOR & Tecnis multifocal IOLs and the astigmatism correcting Toric IOLs. We offer the latest generation of multifocal IOLs with astigmatism correction . To minimize calculation errors in the implanted IOLs we now have the Immersion Biometry which works by the laser interferometry principle. We have performed upwards of 2,000 surgeries annually, with a large number of them being MICS with high end IOLs.
Complicated surgeries being performed at our Hospital are:
1. Intra Ocular Lens Exchange
2. Secondary IOL Implantation
3. Subluxated Cataract Surgery
4. Traumatic Cataract Surgery
Dr. P.C.Sharma Eye Hospital has two state of the art Lasik Laser Machine – Schwind Amaris 750S & Intralase femtosecond 150 AMO (Bladefree) both providing safety, precision and accuracy.
There are two steps in the LASIK procedure. First, the surgeon creates a micro-thin corneal flap, which is lifted to expose the inner cornea for step two, tissue ablation by an excimer laser. The first step of making flap can be done either with ultrathin blade known as Microkeratome (Blade LASIK) or with laser (Blade free LASIK).
The Femto Second (FS) laser introduced the concept of blade-free LASIK, representing the first improvement to the procedure’s first step. Surgeons have found statistically and clinically significant differences in the post procedure vision patients achieve — better than 20/20 to 20/15 and even 20/12.5 — when the laser is used to make the corneal flap.
With its excellent safety profile, patient comfort and superior visual outcomes, Blade free LASIK is among the fastest-growing refractive surgical techniques in the country today. Blade free lasik (Intralase Femtosecond) has an advantage over microkeratome as it provides better wound stability & lesser chances of flap dislocation.
NASA has approved the use of blade less / FS laser in the correction of refractive errors.
SPT (SMART PULSE TECHNOLOGY) :
This technique is the latest technology (2017) to be introduced to our refractive surgery department.
In this technique, refractive error is corrected using laser without any flap formation. This technique is advantageous as is maintains the original strength of the cornea as well as in patients where flap creation is not a viable option.
IMPLANTABLE COLLAMER LENS (ICL)
Implantable contact lenses (ICLs), also known as phakic IOLs, correct vision in much the same way that external contact lenses do, except ICLs are surgically placed inside the eye, where they permanently improve vision. Phakic, from the Greek word "phakos," for lens, refers to artificial lenses that operate in conjunction with the patient's natural lenses.
While ICLs function in almost exactly the same way as contact lenses that sit atop the eye, they are also similar to intraocular lenses (IOLs), which are used during cataract surgery to replace the eye's natural lens after it has been fragmented and removed. However, during ICL surgery, the natural lens is kept in the eye and works with the implanted lens to correct vision.
ICLs are inserted through tiny incisions in the cornea and placed behind or in front of the iris (The colored part of the eye) and in front of the natural lens. These thin, pliable lenses can serve as an alternative to laser eye surgery procedures such as LASIK and are often used to correct conditions that laser procedures may be unable to correct, such as extreme myopia. The ICL procedure produces little to no discomfort for the patient and has a 95 percent average success rate.
Dr. Nishant Sood is a Cornea Specialist at our hospital. The cornea department at our hospital is equipped with :- Anterior segment OCT(As-OCT), Specular microscopy, Anterior segment imaging system, Sirius Topography-Aberrometry. The services provided in cornea department include :
1. Penetrating Keratoplasty : The entire diseased cornea of the host is replaced by a new donor graft & secured with the help of sutures. It can be optical (In cases of cornea scars) or Therapeutic (for non –healing perforated corneal ulcers)
2. Descemets Stripping Endothelial Keratoplasty (DSEK) : The non-functioning endothelial pump of the host cornea is replaced by the healthy donor tissue. The whole cornea is not changed & only the endothelial part is replaced. It can be done in cases of endothelial dystrophies or bullous keratopathy.
3. Deep Anterior Lamellar Keratoplasty (DALK) : The whole cornea, except the descemets membrane & the endothelium are replaced. Chances of rejection in this procedure is minimal as the endothelium is not replaced. It can be done in cases of keratoconus or anterior corneal dystrophies & degenerations.
4. Patch Graft : When only some portion of cornea is affected or perforated, it can be replaced by a small patch of donor corneal tissue.
5. Ocular Surface Disorders : Amniotic membrane grafting can be done in cases of acute chemical injuries, Steven- Johnson syndrome, non –healing epithelial defect etc. Simple Limbal Epithelial Transplantation (SLET) can be done in cases of unilateral or bilateral limbal stem cell deficiency like in cases of chemical injury.
6. Pterygium Surgery : Pterygium (fleshy growth over cornea) is very common in this part of the country. Pterygium surgery is being done with the latest technique of using conjunctival autografting with fibrin glue application.
7. Tissue Adhesive with Bandage Contact Lens (TA-BCL) : This is done for small corneal perforations (<3 mm). The perforation is sealed with the help of cyanoacrylate glue & BCL is applied at the end of procedure.
8. Corneo-Scleral Tear Repair : Open globe injuries involving cornea & sclera should be repaired at the earliest to give best results.
COLLAGEN CROSSLINKING (C3R) EYE TREATMENT
Although many current treatments can improve vision in keratoconus, they do not treat the underlying cause of the corneal weakness and distortion ie they do not stop the progression of keratoconus. Collagen Cross Linking with riboflavin (commonly known as C3R) is one such treatment modality which stops progressive weakening of the cornea that occurs in keratoconus.
The one hour C3-R treatment is performed in the hospital. During the treatment, custom-made riboflavin eye drops are applied to the cornea, which is then activated by ultraviolet A light(370nm). This amazingly simple process has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and strengthen the cornea. In published European studies, such treatments were proven safe and effective in patients.
Keratoconus (KC) is an eye disease in which the central portion of the cornea begins to thin & bulge out. The resulting “cone” shape of the cornea produce a number of unique vision problems including halos, monocular double- vision, ghost images & sensitivity to light.
The various treatment options for keratoconus available at our center are:
1. Corneal Collagen Cross-Linking (C3R/ CXL) :
This is a procedure to strengthen/stiffen the cornea & stop disease progression with the help of UV-A radiation over riboflavin sensitized stromal tissue.
2. Contact Lenses :
Rigid gas permeable (RGP) Lenses include:-
Soft contact lenses can be used in early keratoconus cases.
3. Deep Anterior Lamellar Keratoplasty (DALK) : The whole cornea, except the descemets membrane & the endothelium are replaced. Chances of rejection in this procedure are minimal as the endothelium is not replaced. It can be done in cases of keratoconus or anterior corneal dystrophies & degenerations.
1. Penetrating Keratoplasty :
The entire diseased cornea of the host is replaced by a new donor graft & secured with the help of sutures.
It can be optical (In cases of cornea scars) or Therapeutic (for non –healing perforated corneal ulcers)
2. Descemets Stripping Endothelial Keratoplasty (DSEK) :
The non-functioning endothelial pump of the host cornea is replaced by the healthy donor tissue. The whole cornea is not changed & only the endothelial part is replaced. It can be done in cases of endothelial dystrophies or bullous keratopathy.
3. Deep Anterior Lamellar Keratoplasty (DALK) :
The whole cornea, except the descemets membrane & the endothelium are replaced. Chances of rejection in this procedure is minimal as the endothelium is not replaced. It can be done in cases of keratoconus or anterior corneal dystrophies & degenerations.
PC Sharma Eye Hospital is a major referral center, which deals with medical as well as surgical management of retinal diseases. A well trained retinal surgeon combined with the effective use of latest diagnostic tools brings out optimal visual results.
WHAT TO EXPECT IN RETINAL EXAMINATION
An exclusive retinal examination may be different than a routine eye exam. It involves dilation of your pupils, examination by the specialist and diagnostic testing if required. It may take about three hours for the complete examination. If treatment is recommended for your condition, please allow for some extra time in our office to perform the procedure. Surgical intervention if required can be scheduled at an appropriate time, depending on your condition.
- - An exclusive retinal examination is different than a routine eye exam.
- - It involves dilatation of your pupils, examination by the specialist including indirect ophthalmoscopy and diagnostic testing if required.
- may take about 1½ to 3 hours for complete examination.
- - If treatment is recommended for your condition, please allow for some extra time in our office to perform the procedure.
- - Surgical intervention if required can be scheduled at an appropriate time, depending on your condition.
VITREO-RETINAL SURGERY PLATFORM
Our hospital is equipped with one of the best vitreo-retinal surgery platforms which includes Constellation Vitrectomy system, Opmi Lumera Microscope & Resight Viewing system.
FACILITIES AVAILABLE :
a. Fundus Florescein Angiography (FFA)
b. Optical Coherence Tomography (OCT)
c. B-scan Ultrasonography
d. Fundus Photo (FP)
2. MEDICAL MANAGEMENT
i. Focal/ Grid photocoagulation
ii. Barrage Laser
iii. Pan-retinal photocoagulation
iv. Anterior retinal cryopexy
b. INTRAVITREAL INJECTIONS
i. Anti VEGF – Ranibizumab / Bevacizumab
ii. Ozurdex Implant
iii. Intravitreal triamcinolone acetate
iv. Intravitreal Antibiotics
c. SURGICAL MANAGEMENT
i. Retinal Detachment Surgery
ii. Nucleus/ IOL drop management
iii. Surgery for vitreous hemorrhage
iv. Retained intraocular foreign body removal
v. Management of advanced PDR (Diabetic retinopathy) including TRD & VH.
vi. Post operative Endophthalmitis management
Get your RETINA EXAMINED if you have :
2. MYOPIA or short- sightedness
3. Age related macular degeneration (ARMD)
Glaucoma is the leading causes of irreversible blindness worldwide. In India alone, it affects around 12 million people; India is projected to become the world capital of glaucoma by 2020. The sight loss caused by glaucoma is progressive and, unlike cataract, is irreversible. Fortunately, early diagnosis and treatment can prevent blindness from glaucoma.
WHAT IS GLAUCOMA?
Glaucoma is a disease of the nerve In which there is damage to the optic nerve (nerve for vision) vision caused by increased pressure in the eye.
HOW DOES GLAUCOMA OCCUR?
The inside of the eye contains a fluid, which is being produced and drained out of the eye constantly. It is drained through a sieve like structure situated at the angle between the transparent cornea and the brown coloured iris. When the drainage mechanism becomes ineffective, the pressure in the eye (intra-ocular pressure) increases leading to optic nerve damage which is called glaucoma.
WHAT ARE THE EFFECTS OF GLAUCOMA?
Glaucoma can lead to permanent loss of vision. Initially, the loss of vision starts from periphery and progressively affects the central vision. The central visual acuity is affected only in the advanced stage.
Progressive visual field loss with corresponding damage to optic nerve head in a patient suffering from GLAUCOMA.
INSTRUMENTS USED FOR DIAGNOSIS OF GLAUCOMA
- Medical management of glaucoma
- Lasers- Peripheral Iridotomy, Trabeculoplasty, Iridoplasty
- Sugeries - Trabeculectomy (TRAB), Glaucoma drainage devices (Ahmed Glaucoma Valve -AGV)
- Cryopexy/DLCP for Painful Blind Eye due to Glaucoma
PAEDIATRIC OPHTHALMOLOGY & STRABISMUS (SQUINT)
The Paediatric Ophthalmology service at Dr. P.C.Sharma Eye Hospital was started with a noble aim of bringing back a smile to a child’s face. Over the years the Hospital has grown to be a major referral centre for paediatric eye disorders. At present, this service involves diagnosis and management of various aspects of paediatric eye disorders like refractive error, childhood cataract, glaucoma, amblyopia, squint, retinal disorders, congenital anomalies, but also adult patients with squint/ double vision problems.
- Squint Correction
- Ptosis Correction
- Paediatric Cataract Surgery
- Amblyopia Management
P.C.Sharma Eye Hospital conducts once a month visit to Nahan & Paonta Sahib (Himachal Pradesh) and cataract surgeries are being performed there at an affordable cost for the local patients.
Besides this we also conduct once a month free camp at Vill. Azizpur Kalan, Yamunanagar(Haryana).