CATARACT SURGERY

Cataract surgery is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract. Cataract causes impairment or loss of vision. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's transparency.

Types of surgery

Extracapsular cataract extraction involves the removal of almost the entire natural lens while the elastic lens capsule (posterior capsule) is left intact to allow implantation of an intraocular lens. There are two main types of cataract surgery – Phacoemulsification and Conventional extracapular extraction.

Am I the right candidate?

An eye examination or pre-operative evaluation by an eye surgeon is necessary to confirm the presence of a cataract and to determine if the patient is a suitable candidate for surgery.

PHACOEMULSIFICATION

Phacoemulsification (Phaco) is the preferred method in most cases. It involves the use of a machine with an ultrasonic handpiece equipped with a titanium or steel tip.

The tip vibrates at ultrasonic frequency (40,000 Hz) and the lens material is emulsified. A second fine instrument (sometimes called a cracker or chopper) may be used from a side port to facilitate cracking or chopping of the nucleus into smaller pieces. Fragmentation into smaller pieces makes emulsification easier, as well as the aspiration of cortical material (soft part of the lens around the nucleus).

After phacoemulsification of the lens nucleus and cortical material is completed, a dual irrigation-aspiration (I-A) probe or a bimanual I-A system is used to aspirate out the remaining peripheral cortical material.

CONVENTION EXTRACAPSULAR CATARACT EXTRACTION

Conventional extracapsular cataract extraction (ECCE): It involves manual expression of the lens through a large (usually 10–12 mm) incision made in the cornea or sclera. Although it requires a larger incision and the use of stitches, the conventional method may be indicated for patients with very hard cataracts or other situations in which phacoemulsification is problematic. Microincision cataract surgery involves a technique by which a cataract can be reached through an incision of 1.5 millimeters or less.

Operation procedures

Following cataract removal (via ECCE or phacoemulsification, as described above), an intraocular lens (IOL) is usually inserted. After the IOL is inserted, the surgeon checks that the incision does not leak fluid. This is a very important step, since wound leakage increases the risk of unwanted microrganisms to gain access into the eye and predispose to endophathalmitis. An antibiotic/steroid combination eye drop is put and an eye shield may be applied on the operated eye, sometimes supplemented with an eye patch.

How long do I have to be hospitalized?

Most cataract operations are performed under a local anaesthetic, allowing the patient to go home the same day. The use of an eye patch may be indicated, usually for about some hours, after which the patient is instructed to start using the eyedrops to control the inflammation and the antibiotics that prevent infection.

Recovery and Recuperation

After the surgery, the patient is instructed to use anti-inflammatory and antibiotic eye drops for up to two weeks (depending on the inflammation status of the eye and some other variables). The eye surgeon will judge, based on each patient's idiosyncrasies, the time length to use the eye drops. The eye will be mostly recovered within a week, and complete recovery should be expected in about a month.

For more information please register

Disclaimer; Contact Us Powered by IXCHEL © 2010