SENILE CATARACT

Dr. PRANESH KULKARNI

PROF. & HOD
Dept. of Ophthalmology
KBNIMS
Immature senile cataract
 Opacification becomes more diffuse and irregular.
 Lens is swollen
 Iris shadow +
 AC: shallow
Morgagnian hyper-mature cataract
● Complete cortex is liquefied and appears milky
white in colour.
● Nucleus settles at the bottom
● Calcium deposits may also be seen on the lens
capsule.
Sclerotic hyper-mature cataract
 Disintegrated cortex.
 Shrunken lens
 Wrinkled anterior capsule
 Dense white capsular cataract in pupillary area.
 Deep anterior-chamber.
 Tremulous Iris
Complications of senile cataract

1.Phacoanaphylactic uveitis
2.Lens induced glaucoma
3.Subluxation or dislocation of lens
Manual Small Incision Cataract Surgery

I . Superior rectus bridle suture is taken and secured

2. Conjunctival flap and exposure of sclera
3. Haemostasis is achieved by wet field cautery
4 . A self-sealing sclerocorneal tunnel incision is
made
5. Side-port entry made
6. Anterior capsulotomy
7. Hydrodissection
8. Nuclear management. Il consists of following
manoeuvres:
i. Prolapse of nucleus by rotating the nucleus with
Sinskey's hook
ii. Delivery of the nucleus
• Irrigating wire vectis method
• Blumenthal's technique
• Phacosandwich technique
• Phacofracture technique
• Fishhook technique
9 . Aspiration of cortex: The remaining cortex is
aspirated out using a two-way irrigation and
aspiration cannula
1O. IOL implantation
11. Removal of viscoelastic material with the help of
two-way irrigation aspiration cannula
12. Wound closure