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The surgery described above did lot of good to the cataract patient by restoring vision. But it also had its own problems. One had to wait long for the cataract to mature, thus loosing years of active work. Removal of the lens got rid of the cataract but rendered the person lens less, a condition called "aphakia". This meant that the person will have to wear a lens in the form of glasses to see and focus on objects without which the vision was not proper. Research was going on at that time about the feasibility of placing an artificial lens in place of the removed one. Though the surgical procedure was already described, it was delayed for actual use in practice for discovery of appropriate implant able material and methods to select proper size and focal length of the artificial lens to be implanted.
By 1975, the news of artificial lens implants within the eye, "the IOL"(intra-ocular lens), started coming up from various centres in India and abroad. This time it was the turn of my sister to undergo the operation which was done in Bombay. In Goa however the old methods continued till about 1984, when a young lady Ophthalmic surgeon Dr Alethea Barbosa, announced the first IOL implant in Goa, which she did in Asilo hospital in Mapusa. Several young surgeons of Goa then followed the suit.
Lens implant in initial days involved an incision on the cornea just like old operations. The removal of cataract material form the lens capsule and carefully preserving the capsule for facilitating IOL implant was a cumbersome process. Medical research has simplified the process further and varieties of new artificial implants made up of "acrylic" which are "foldable" and "flexible" are now available which can be introduced through button holes in the cornea, thus making the procedures simple, less cumbersome to the surgeon and less traumatic to the patient with high quality vision post-operatively. What is also important is that one need not wait for the cataract to mature like the good old days but it can be removed in the early stage of its formation.
So when my turn came for a cataract operation last year (1999), it was the latest technique called "Phaco-emulsification". This involves a 3mm botton hole incision on cornea through which an ultrasound probe is introduced in the lens. Computer guided ultrasound frequency is than applied which emulsifies the lens material without damaging the capsule. The lens material is than sucked out and a selected IOL is placed in the lens capsule. The corneal incision need not be stitched. It is sealed away by cauterization. The person need not wait in the hospital. he is discharged within hours.
And just a week ago (8-6-2000) when I underwent operation on my other Eye, the technique of Phaco-emulsification remained same but the incision in the cornea was still smaller (2.8mm) as the IOL quality has improved and the flexible and foldable IOL made up of acrylic material allows itself to be introduced through smaller incision.
That this sophisticated surgery on both my eyes was done here in Goa at "My Eye Hospital" in Margao was the biggest satisfaction to me. That it was performed by two Goan eye surgeons, Dr. Chandrakant Gaunker and his wife Dr. Madhavi Gaunker, both students of Goa medical college and my own students in under-graduate years, adds to my pride. That Dr. Chandrakant and Dr. Madhavi are lions club members is an added satisfaction. The standby anaesthetist for me was Dr. Maya Lawande, again a student of mine. And myself being a case of "Hypertrophic Cardiomyopathy", needed a physician as standby, a job performed well by my colleague from NUSI-South Goa Hospital, Dr. Terence D'Costa.