Cataract (Motibindu) Surgery Cost in Nepal: What You Need to Know
Cataract (Motibindu) Surgery Cost in Nepal: What You Need to Know
25 August 2024

Cataract surgery is one of the quickest and safest surgeries to remove the clouded lens of the eyes. Those who suffer from glare and halos around light can be prone to cataracts developed early in life. Remember, analysis of your situation and getting the right treatment on time can save you from losing your precious vision. Not limited to that, after cataract surgery, patients report they can drive, read, and see colors more vibrantly. Today we learn about the motibindu surgical procedure in Nepal, its cost, and some slight risks associated with it.

Michael Chua, MD on Cataract Surgery

Expert cataract and refractive error surgeon, Michael Chua, MD explained cataract surgery in a very helpful way. He introduces cataracts and the requirement for surgery in his YouTube video, “As you get older, the protein within the eye lens can begin to clump together and form deposits. These deposits cause the lens to become cloudy and scatter the light passing through the lens. It's the scattering of the light that causes the symptoms usually associated with cataracts. “ He adds that improved vision is the primary benefit; one can have no more foggy lenses impairing your ability to see in broad daylight and at night as well. Fine visual details allow you for a safe driving experience and do your hobby of painting too.

Things to keep in mind before the Cataract operation for great vision

  • You need to wear a disposable mask, head cap, and clean gown before entering the OT.
  • Your eyes get clean so that the area is contamination-free.
  • The antimicrobial solution, to clean the area of operation (it is outside the skin) but some sensation may arise in the eyes.
  • After cleaning do not touch it with your hands, as this may be contaminated.
  • Keep your head upright and keep drops in eyes, close your eyes for 2 minutes.
  • Chances are there that extra drops might flow from the corner, in such case don't panic.
  • Be comfortable and wait for your turn to operate.
  • Once the Speculum is placed on your eyelids, don’t move much during the cataract procedure.
  • Don't blink your eyes hard or rub them, follow the instructions of the doctor.
  • The eyes are once again made contaminated-free and a clean aseptic drape will be placed on you.

Suitable Cataract (Motibindu) Surgery Options based on its Type

Cataract Type Surgery Technique Description
Senile Cataracts Phacoemulsification (Phaco) uses ultrasound to break the foggy lens and remove it through a small incision.
Small Incision Cataract Surgery (SICS) Larger incision, manual removal of lens.
Congenital Cataracts Phaco or SICS Same technique as for senile cataracts.
Early diagnosis and surgery Essential to prevent amblyopia
Traumatic Cataracts Delayed surgery Surgery is often delayed until the eye heals from an injury.
Phaco or SICS The same techniques as for senile cataracts, with modifications based on injury.
Secondary Cataracts (Posterior Capsular Opacification) Nd: YAG laser capsulotomy Uses a laser to create an opening in the cloudy posterior capsule.
Rarely, additional surgery May be required if laser treatment is ineffective.

How is motibindu surgery performed in Nepal?

Cataract surgery, known as "Motibindu" in Nepal, is typically performed using the phacoemulsification and SICS technique. Let's break down the quite complex procedure into 10 steps, for you to understand what you have to go through during the motibindu surgery.

 

 Cataract Surgery Timeline 

Step 1: Numb Eye with Local Anesthesia

Local anesthesia aka topical anesthetic eye drops, is given to numb the eye. In addition, the anesthesiologist also gives you light sedation to relax you during the procedure.

Step 2: Dilate the pupil with eye drops

The mydriatic eye drops, such as phenylephrine and cyclopentolate, are used in combination to dilute the pupil multiple times, usually 30 minutes before surgery.

Step 3: Make an incision in the cornea

A femtosecond laser AI-powered machine or other manual machine is used to make an incision to remove the cloudy lens. It is based on the type of cataract surgery you choose. In this case, patients are brought to Femto OT, in front of the AI-laser machine.

The patient lies on the bed, in front of the AI-powered femto machine, under the cataract surgeon's supervision. A clean sheet will be placed on your eyes. Once this is placed, you don’t have to move. And then an instrument named the Universal Eye Speculum will be used to open your eyelids so that the eyes won't close.

After that, a disposable patient interfaces on the tip of the machine so that there is no infection or contamination in the eyes. To make an incision, the patient needs to see inside the red blinking light, around which are 6 lights, You focus on that red light.

In other basic operations like MICS, Phaco, or MicroPhaco, the laser step is skipped, You are taken directly to OT, and the lens is cut, broken, and removed using a different procedure.

Step 4: Break up cloudy lens

In the Phacoemulsification technique of cataract surgery, a thin ultrasound probe is inserted into the eye. This probe helps to make an incision and break that cloudy lens into tiny fragments. Your eyes may be blurry at the time, but the laser will take 10 to 20 seconds, with no pain and pressure in the eyes, to make incisions and break up cloudy lenses.

Step 5: Remove lens pieces with suction

The eye doctor uses special instruments and probes to break up the cloudy lens into small pieces, which are then suctioned out of the eyes. Once the cloudy lens is removed, the patient is ready for the new step.

Step 6: Fold and insert IOL

An artificial lens called an intraocular lens or IOL, is to be inserted into the eye to replace the natural lens. For that, you may be shifted to the main OT, and a plastic-like transparent IOL is inserted where the incision is made in your eyes.

Step 7: Position IOL in the capsule

When the natural lens is removed through the small one- to two-millimeter incisions made on the cornea, it is replaced with a new lens. Light passes from the microscope; you have to look at that light during your operation. Keep looking at the microscope light above you during the whole process. It just takes 10 to 15 minutes to replace and position IOL in the capsule.

Step 8: Self-sealing incision

No injection is used, there is no pain in the eyes, and no stitch or bandage is used. It's a self-sealing incision that recovers your vision, in around 2 to 4 weeks of rest.

Step 9: Rest in recovery area

The patient is gently lifted and brought outside OT, now he can rest in the recovery area for some time. Moreover, one is asked to wear black goggles and get discharged within an hour.

Step 10: Prescribe Eye drops

The eye doctor will discharge patients on the same day of the operation, no need to stay overnight at the hospital until there is a super emergency. Likewise, they will be informed about post-operative eye drops, and medications and suggested to take adequate rest at home.

Cataract Surgery Cost in Nepal

Types of Cataract Surgery Price of Surgery
Govt. Support-based Cataract Surgery 8500
YAG Capsulotomy/PI 1200
Capsular Tension Ring (CTR) 1700

This is the basic cost. For customization options for Small Incision Cataract Surgery with different lenses and Phaco Cataract surgery, find the pricing option below.

Types of Cataract Surgery Price of Surgery
Govt Support-based Cataract Surgery 8500
YAG Capsulotomy/PI 1200
Capsular Tension Ring (CTR) 1700

Abbreviation

SICS: Small Incision Cataract Surgery

PC IOL: Posterior Chamber Intraocular Lens Implant

AC IOL: Anterior Chamber Intraocular Lens

SF IOL: Single Focus Intraocular Lens

Post-operative Instructions for Motibindu Patients

The patient strictly needs to wear a pair of sunglasses after surgery. It’s because, after a hazy cataract surgery, it becomes essential for one to adapt to the outside world with caution to avoid strain and pressure in the eyes, with bright daylight. It might be a little bit uncomfortable at times, so the use of sunglasses whenever you go outside at least for the first two weeks is a must. On top of that, sunglasses help you protect debris pollen, or wind in the outside environment. Doctors give you a clear plastic shield after surgery and recommend placing the shield over your eye at night before sleeping for one week straight. It comes with tape for easy sticking over the eye. Using a shield can prevent you from accidental injury caused by rubbing your eye on the pillow while asleep. No special head positioning is required to sleep; just be more cautious during the shower and outdoor activity. Some of the post-operative symptoms can be seen as,

  • Grittiness and irritation of the eyes
  • Eyes are often dry and red unlike before
  • Blurry unclear vision during the healing period
  • Mild swelling around the eyelid
  • New Floaters and halos around the eyes
  • Nausea due to exposure to anesthesia
  • Increased intraocular pressure

Severe pain, headache, or eye pressure sudden decrease in vision worsening redness continued sensitivity to light however can be concerning. See a doctor if your symptoms progress and impact your overall well-being.

Conclusion

Cataract surgery is well-tolerated eye surgery, however, it is associated with the risk of dry eye condition, postoperative eye infection/Endophthalmitis, retinal tears, and other conditions. An individual can return to their previous condition within a few weeks if no issues of posterior capsular tears are seen. Ensure that your eyes are the primary focus of your health care. If you have any concerns regarding symptoms of cataracts, don’t hesitate to consult with an eye care professional near you. Also, you can book your appointment online with Vision Concern Clinic.