CATARACT EXTRACTION (Cataract Surgery)

Cataract surgery is a procedure performed to remove a cloudy lens from the eye; usually an intraocular lens is implanted at the same time.

The purpose of cataract surgery is to restore clear vision. It is indicated when cloudy vision due to cataracts has progressed to such an extent that it interferes with normal daily activities. It is one of the most commonly performed surgical procedures in the world.

2 Types of Cataract Extraction

is the removal of both the lens and the thin capsule that surround the lens. This type of surgery was common before 1980, but has since been displaced by extracapsular surgery. Removal of the capsule requires a large incision and doesn't allow comfortable intraocular lens implantation. Thus, people who undergo intracapsular cataract surgery have long recovery periods and have to wear very thick glasses.

is the removal of the lens where the capsuleis left in place.

Two methods for extracapsular cataract surgery: The usual technique is phacoemulsification. A tiny incision (about 0.12in or 3 mm long) is made next to the cornea (the eye's outer covering), and an ultrasonic probe is used to break the cataract into minute pieces, which are then removed by suction.

When the lens is too hard to be emulsified ultrasonically, the surgeon will use a different extracapsular technique requiring a larger incision. An incision about 0.37 in (9 mm) inches long is made, and the whole lens (without its capsule) is removed through the incision. Both kinds of extracapsular extraction leave the back of the capsule intact, so a silicone or plastic intraocular lens can be stably implanted in about the same location as the original lens. The surgery takes about 30-60 minutes per eye.

PROCEDURE

Patients must have a pre-operation eye examination, which will include ultrasound analysis to make sure the retina (the innermost layer of the eye, containing the light receptors) is intact and also to measure eye curvature so that a lens with the proper correction can be implanted. The patient also will have a preoperative physical examination. In addition, patients start a course of antibiotic eye drops or ointment the day before surgery.

Proper post-operative care is especially important after cataract surgery. Patients will need someone to drive them home after the surgery and should not bend over or do anything strenuous for about two weeks. They should refrain from rubbing the eye, should wear glasses to protect their eye, and should wear a shield while sleeping so the eye won't be rubbed or bumped accidentally. The patient will usually continue their antibiotic for two to three weeks and will also take anti-inflammatory medication for about the same length of time. If the patient experiences inflammation, redness, or pain, they should seek immediate medical treatment to avoid serious complications.

Cataract surgery itself is quite safe; over 90% of the time, there are no complications. Possible complications include intraocular infection (endophthalmitis), central retinal inflammation (macular edema), post-operative glaucoma, retinal detachment, bleeding under the retina (choroidal hemorrhage), and tiny lens fragments in the back (vitreous) cavity of the eye, all of which can lead to loss of sight.

Since increased use of the phacoemulsification method of cataract surgery, researchers have noted a decline in cases of infection (endophthalmitis). This probably is because injectable intraocular lenses do not make contact with the ocular surface. In 2004, the FDA approved a new capsular tension ring for use in cataract surgery that helps prevent lens dislocation and other possible complications of surgery

Ordinarily, patients experience improved visual acuity and improved perception of the vividness of colors, leading to increased abilities in many activities, including reading, needlework, driving, golf, and tennis, for example. In addition, sometimes implanted corrective lenses eliminate the need for eyeglasses or contact lenses. Researchers and manufacturers also continue to work to improve the lenses available in cataract surgeries, so that eventual vision and outcome are improved.

EQUIPMENTS FOR SURGERY

Caliper Speculum Wire Wescott Scissors .12 Tissue Forceps Utrata Capsulorhexis Forceps Mcpherson Angled Tying Forceps Mcpherson Straight Tying Forceps Locking Needle Holder 19ga. Bishop Harmon Cannula Beaver Handle Iris Spatula Kuglen Lester IOL Manipulator Sinskey Hook

Bechert Nucleus Rotator Corneal Scissor (Right and Left) Vannas Scissor .12 Colibri Tissue Forceps Lens Loop Irrigation / Aspiration Set Stainless Steel I/A Handpiece

Tip, Straight Tip, 90 Degree Tip, 45 Degree Tip, "J" Shaped Tip, Soft Curve Forcep, Angled Bipolar Plastic Irrigating Cannula Handpiece

Prepared by:
John Rey Hesita