Cataract is the clouding of the natural lens of the eye. This results in blurring of vision and if left untreated it can even cause blindness. Cataract surgery is the commonest surgery performed in the world. It is also the most safely performed operation with the highest success rate.

Since the past 3 decades, phacoemulsification or phaco with intraocular lens (IOL) implantation is the preferred technique for cataract surgery. It involves a microincision (<2mm) into the eye, through which cataract is removed by ultrasonic energy and an artificial lens or IOL is implanted to restore the vision. The surgery typically lasts not more than 10 to 15 minutes.

Cataract Surgery: Maintaining safety from COVID-19 Infection

During this coronavirus pandemic the most important concern for patients with cataract is the risk of acquiring covid19 infection during surgery. So let’s first understand how a coronavirus infection may be acquired. The most common source of infection is inhaling aerosol generated during coughing, speaking or sneezing by an infected person. Second is through fomites or surfaces.

The virus survives on hard surfaces and only if a person touches his nose, mouth or eyes, he may infect himself with the virus. These two methods of acquiring infection may be avoided by wearing masks, practicing hand hygiene and avoiding touching the face, as we already know by now.

Next we need to understand what happens during cataract surgery. There is no or minimal aerosol generation during cataract surgery. This is because it is a microincision surgery with self sealing wounds and the patient’s face is completely covered with a sterile drape during surgery. (Figure 1).

cataract surgery.

Figure 1. Eye draped before cataract surgery.

Secondly, since the surgery lasts only 10 to 15 minutes, the exposure time is too short to acquire infection.

Though the risk of acquiring Covid19 infection is almost nil during cataract surgery, it is also important to know about the efforts taken by an NABH accredited eye hospital like Neoretina in providing patients with the highest standard of safety:

  1. All patients and attenders are screened at the entrance. Temperature is checked and hand sanitizer is provided.
  2. Entry without a mask is not allowed. In case a patient walks in without a mask, a mask is provided by the hospital.
  3. Only one attender is allowed per patient.
  4. Patients are encouraged to visit the hospital only by appointment
  5. The hospital staff and doctors wear essential personal protective equipment (PPE).
  6. Regular sanitization and disinfection of surfaces is performed throughout the day.
  7. Strict hand hygiene protocols are in place.
  8. Social distancing is practiced and only alternate chairs are available for seating in the waiting area.
  9. Inside the operation theatre:
  • The operation theatre (OT) is equipped with air handling units which ensures the OT environment is safe from microorganisms (Figure 2).
  • Only one patient is operated in the operation theatre at a given time.
  • The patient’s eye is cleaned with a betadine solution before surgery.
  • Every patient is provided with a new disposable cap, mask and foot cover before surgery.
  • Almost all surgeries are performed under topical anaesthesia i.e. eye is numbed only with eye drops. Since it is a no injection procedure, it is painless as well as free from risk of bleeding and infection.
  • Only disposable single use instruments are used.
  • After every case, trolly sheets are changed.
  • New sheets and drapes are used for every patient.
  • After every case the operation theatre is cleaned thoroughly.

Operation theatre

Figure 2. Operation theatre with air handling unit.

With all the sophisticated techniques and safety protocols in place, now patients can confidently book their appointment for a walk-in walk-out cataract surgery and experience the joy of clear vision.

 

Dr Abhilasha Baharani

Dr Abhilasha Baharani

DNB FRCS (Glasg) FICO Uvea & Cataract Specialist at Neoretina
Dr. Abhilasha Baharani is a specialist in Uveitis and Ocular inflammation. Her areas of expertise are Uveitis & Ocular Immunology- management of ocular tuberculosis, immunosuppressive therapy for non-infectious uveitis & scleritis, phacoemulsification in small pupil, complicated cataracts and ocular manifestations of systemic diseases. She studied MBBS at Kasturba Medical College Mangalore and DNB at Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Tirunelveli. She did her fellowship in Uveitis & Ocular Inflammation at Aravind Eye Hospital & Post-Graduate Institute of Ophthalmology, Madurai and a second fellowship in Ocular Inflammatory Disease in Vitreoretinal Disorders at the Royal Victoria Eye and Ear Hospital, Dublin, Ireland where she became well-versed with newer immunosuppressive agents and use of biologic blockers. She is a member of the International Ocular Inflammation Society and is an active member of the state and national academic societies. She has received the Carl Herbort Award for her research paper at the Uveitis Society of India Annual Meeting in 2012 and Award of Distinction and Award of Merit for her research papers at the International Ophthalmology Congress- Innovations and Challenges in Glaucoma & Uveitis, Singapore, 2014.
Dr Abhilasha Baharani