Professional Documents
Culture Documents
EXTRACTION
EYE DEPARTMENT
PMC-AJK
METHODS
• Couching (criminal)
• ECCE (discontinued)
• ICCE (discontinued)
• ICCE with AC IOL (discontinued)
• ECCE with PC IOL (most common)
• Phacoemulsification with foldable IOL (most common in developed countries)
• MSICS with PC IOL (manual phaco/poor mans phaco) (gaining popularity)
• Laser assisted cataract surgery (future trend)
AIMS OF SURGERY
Faster Visual rehabilitation
Smallest incision
Minimum complications
Unaided good vision
IOL implantation
To reduce astigmatism ( keep wound as peripheral and as small as possible)
Incision caused weakening of wound and a plus cylinder in axis of wound
Up to 0.75 diopter acceptable
ICCE large wound 3 diopter astigmatism
ECCE 2-2.5 diopter astigmatism
MSICS 0.75 diopter astigmatism
Phaco 0.50 diopter astigmatism
HISTORY OF CATARACT SURGERY
• The word “cataract” stems from the Greek word for “waterfall,”
• It was not until the late 1840s that general anesthesia was
introduced for surgical procedures. By 1884, anesthesia in the form
of eye drops (cocaine) was developed.
• Investigations
• Routine Blood CP, ESR, RBS,
• Urine RE
• Screening for Hepatitis B and C
• Bio-metery
• Any other investigation necessary due to the co-existing medical
disorder
PRE OPERATIVE MEDICATIONS
• Sedation
• Antibiotic drops
• IOP lowering drug (AZM)
• Continue medication of DM HT
• Immediately pre op
• 1. antibiotic
• 2. mydriatic
• 3. topical anaesthetic
PHACOEMULSIFICATION
• Systemic analgesics
• systemic antibiotic
• antibiotic steroid combination drops
• Mydriatic drops
POST OPERATIVE PRECAUTIONS
• Aphakic glasses
• Limbal scar
• Deep anterior chamber
• Iridectomy
• Iridodonesis
• Jet black pupil
DUE TO ANESTHETIC (DRUG AND
TECHNIQUE)
• Striate keratitis
• Sub-conjunctival hemorrhage • Acute bacterial Endophthalmitis
• Retained lens matter • CMO
• Raised IOP • Wound leak
• Wound leak and iris prolapose • High astigmatism
• Decentered IOL • Wrong powered IOL
• Hyphema
LATE
• Suture related complications
• PCO
• Pupillary lens capture
• Vitreous loss related complications (endothelial decompensation, CMO,
persistent uveitis, UGH syndrome, wick syndrome, RD, Glaucoma)
• Epithelial ingrowth
• Glaucoma
• Retinal detachment
• Chronic endophthalmitis
DISPLACEMENT OF THE LENS
•
Etiology
Ocular
• Injury
• bubhthalmos
Hypermture cataract
• Systemic
• Marfan’s syndrome
• Marchesani’s syndrome
• Homocystinuria
• Ehlers-Danlos syndrome