|
|
 |
|
|
When vitiated dosas reach the fourth patala, vision gets obstructed all around. This
condition is termed linganasa (Cataract).
|
|
Surgery of immature cataract
|
 |
- In immature cataract, the lens is dislocated downwards; it again floats up and produces reddish-white appearance, severe pain in the eye and loss of vision.
- In this case, the eye should be irrigated with ghrta processed with the drugs of madhura group as well as sirovasti
and a non-vegetarian diet should be given.
|
| Surgery of mature cataract |
|
- In mature cataract, the appearance is dense and covers the whole papillary area, disappears as soon as it comes in contact with the tip of salaka (needle).
- The cataract can reappear on account of injury to the head, physical exercise, sexual intercourse, vomiting, fainting, anger and when an immature cataract is pierced.
|
|
Operative procedure of Cataract
|
|
Pre-operative procedures
|
|
- In neither too hot nor too cold weather the patient should be subjected to
oleation and sudation.
- He should be made to sit and positioned properly after which he should be asked to fix his gaze towards his own nose continuously.
|
|
Operative procedure
|
|
- The surgeon should hold a barley-shaped salaka (rod like instrument) instrument between the thumb, middle finger and index finger of his right hand and should open his eyes and puncture the eyeball properly with confidence towards the temporal canthus avoiding two parts of the white of the eye from the cornea.
- The puncture should be made neither too high nor too low, nor at the sides and saving the network of veins.
- It should then be directed towards the natural orifice (Pupil).
- The surgeon should operate with his right hand on the left eye and with his left hand on the right eye.
- The proper puncturing is recognized by the production of a typical sound and by the out-flow of a drop of liquid.
- After the puncture has done, the salaka should be held firmly in proper position while the eye should be irrigated with human milk and fomented with vata-pacifying leaves from outside irrespective of the dosa being stable or mobile.
- Then the substances of the lens should be punctured and scraped with the point of the salaka and the patient should be made to blow out violently the kapha which has accumulated in the lens after closing the nostril of the opposite side.
|
|
Post-operative procedure
|
|
- When the patient is able to visualize objects, the salaka should be withdrawn slowly.
- The eye should then be lubricated with ghrta and bandaged with a cloth.
- Then the patient should be made to lie supine in a room free from disturbing agencies (like dust, smoke, blasts of wind, the sun, et.).
- The patient should be instructed to avoid belching, coughing, sneezing, spitting and shivering during the period.
|
|
Subsequent care after operation
|
|
- Every third day the eye should be washed with the vata-allaying decoctions such as Triphala kwath and should be fomented from third day onwards as before to avoid the danger of vata vitiation.
- Having observed this regimen for ten days measures to improve the vision along with the other postoperative care and light diet in moderate quantity should be given.
|
|
Post-operative complications
|
|
Complications resulting due to technical errors during operation or from a harmful regimen after the operation are as follows-
- Redness,
- Inflammation,
- New growths,
- Sucking pain,
- Bubble like projections,
- Squint.
|
|
Technical Complications of surgery and their treatment
|
|
- In case a vein is punctured, the eye gets filled with blood. In that
condition ghrta cooked with human milk along with madhuyasti is beneficial.
- In case of inadvertent puncture near the outer canthus, swelling, pain and sanguineous tears follow. In that condition poultice should be applied between the eyebrows and irrigation should be done with warm ghrta.
- In case of an inadvertent puncture in the vicinity of cornea, redness and pain in the corneal region occur. In that condition purgation, irrigation with ghrta and blood letting should be carried out.
- In case of inadvertent puncture on the superior aspect, severe pain is produced. In that condition irrigation with lukewarm ghrta is recommended.
- In case of an inadvertent puncture on the inferior aspect, excessive pain, lacrimation and redness occur and upon
withdrawal of the needle (salaka), slimy discharge follows. In that condition treatment should be carried out as before.
- In case of excessive injury, redness, lacrimation, pain, indurations and horrification occur. In that condition oleation therapy, sudation and oily
enema (anuvasana) are beneficial.
|
|
Treatment to get rid of pain and redness after surgery
|
|
- A lukewarm application of a compound gairika, sariva, durva, barley paste, ghrta and milk should be applied
as remedy for pain and redness.
- Mildly fried tila combined with white sarsapa and the juice of matulunga is also as effective as the previous one.
- A lukewarm application of ksirapuspi, sariva, tejpatra, manjistha and madhuyasthi pasted with goat's milk is said to be efficacious.
- Daruharidra, padmaka and sunthi pasted with goat's milk or draksh.
Madhuyasthi, kustha and rock salt pasted with goat's milk or else goat's milk processed with lodhra, rock salt, mrdvika and madhuyasti used for irrigations, eradicate pain and redness.
- Milk processed with madhuyasti, utpala and kustha or with draksha, laksha and sugar with rock salt added to it, relives pain and redness.
- Ghrta processed with satavari, prthkaparni, mustaka, amalki, padmaksa and goat's milk eradicates burning sensation and pain.
- Ghrta processed with four times of milk already boiled with the
vata-suppressive drugs.
- In case pain does not subside with these measures, the surgeon should do venepuncture after oleation and sudation therapies or else should apply cautery (either by caustics or by fire) as indicated.
|
|
|
|
|
|
|
|
|
|
|
|
Stages of Surgery
