Cataract Surgery

CATARACT SURGERY


CATARACT SURGERY

  • Treatment of choice i.e. surgical removal of cataractous lens.

INDICATIONS

1. Optical indications:

  • To improve vision in a visually handicap patient.
  • This is the most common indication.

2. Medical indications:

  • Cataract needs to be removed urgently even if patient has good vision.

Such good conditions are:

  1. Lens induced glaucoma or uveitis
  2. Phacoanaphylactic endophthalmitis
  3. Dislocated/subluxated lens
  4. Retinal detachment or diabetic retinopathy

3. Cosmetic indication:

  • White pupil in mature cataract is unacceptable to some young patient &
  • in order to obtain black pupil cataract extraction is indicated.

OPERATIVE TECHNIQUES

1. Extracapsular catarct extraction (ECCE)

  • The nucleus, cortex & central part of the anterior capsule are removed.
  • Leaving behind intact posterior capsule, peripheral part of anterior capsule & zonules.
  • ECCE with posterior chamber lens implantation (ECCE with PCL) is the surgery of choice for almost all types of cataract.
  • Absolute contraindication for ECCE is subluxation & dislocation of lens.

Techniques for ECCE are:

  1. Conventional ECCE
  2. Manual small incision cataract surgery
  3. Phacoemulsion

2. Intracapsular cataract extraction (ICCE)

  • Only indication is markedly subluxated or dislocated lens.
  • Contraindicated in young patients (

3. Phacoemulsion

  • Advancement in the method of doing ECCE.
  • ECCE by phacoemulsification with foldable posterior chamber IOL is the procedure of choice for cataract.

Steps in phacoemulsion include:

  1. Corneoscleral incision
  2. Continuous curvilinear capsulorrhexis
  3. Hydrodissection & hydrodelineation
  4. Emulsification & aspiration of nucleus & then cortex
  5. Foldable IOL implantation in posterior chamber.
  • Recovery with phacoemulsification is fastest as incision is very small & no sutures are taken.

Exam Important

  • Surgery of choice for congenital cataract is ECCE.
  • In extra-capsular cataract surgery [ECCE], Nucleus of the lens is excised
  • Best way to prevent infection after cataract surgery is Antibiotics.
  • Surgery of choice for congenital cataract is Posterior capsulectomy.
  • Laser used to manage after cataract- Nd:YAG laser.
  • In posterior capsular cataract, treatment is Nd-YAG Laser.
  • Laser used in cutting out cataract capsule is Nd : YAG laser.
Don’t Forget to Solve all the previous Year Question asked on CATARACT SURGERY

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