Phaco and Micro Surgery


Cataract

A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil. When the lens becomes opaque, light cannot pass through it and the vision becomes dim or blurred as the transparency of the lens is lost. A cataract is not a growth or a film over the eye.

Cataract formation is a natural process of the eye’s aging, Cataract surgery is a common procedure; most people regain the vision they had earlier with the help of microsurgery. The procedure has a 98% success rate. There is very little discomfort or inconvenience and patients can usually return home few hours after surgery. We offer the best cataract surgery for adults & children.

Cataract

Causes

The most common cause of cataract is degeneration of lens protein due to age. There may be other causes like diabetes, kidney disease, glaucoma, smoking, eye injuries, infection, and inflammation inside the eye which can be responsible for the cataract. Besides these reasons, cataract can also develop due to exposure to UV rays or prolonged use of certain medications.



Phaco

Phacoemulsification is a modern cataract surgery in which the eye's internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye. Aspirated fluids is replaced with irrigation of balanced salt solution to maintain the anterior chamber.



Surgical technique

Cataract

Phacoemulsification and implantation of intraocular lens (IOL)

In the process of phacoemulsification can be performed, one or more incisions are made in the eye to allow the introduction of surgical instruments. The surgeon then removes the anterior pare of the capsule that covers the lens inside the eye. Phacoemulsification surgery involves the use of a machine with microprocessor-controlled fluid dynamics. These can be based on peristaltic or a venturi type of pump.

The phaco probe is an ultrasonic hand piece with a titanium or steel needle. The tip of the needle vibrates at ultrasonic frequency to sculpt and emulsify the cataract while the pump aspirates particles through the tip. A second fine steel instrument called a "chopper" is used from a side port to help with chopping the nucleus into smaller pieces. The cataract is usually broken into two or four pieces and each piece is emulsified and aspirated out with suction. The nucleus emulsification makes it easier to aspirate the particles. After removing all hard central lens nucleus with phacoemulsification, the softer outer lens cortex is removed with suction only.

An irrigation-aspiration probe or a bimanual system is used to aspirate out the remaining peripheral cortical matter, while leaving the posterior capsule intact. As with other cataract extraction procedures, an intraocular lens implant (IOL), is placed into the remaining lens capsule(In the Bag implantation). For implanting a poly(methyl methacrylate) (PMMA) IOL, the incision has to be enlarged. For implanting a foldable IOL, the incision does not have to be enlarged. The foldable IOL, made of silicone or acrylic of appropriate power is folded either using a holder/folder, or a proprietary insertion device provided along with the IOL.

Sometimes, a culiary sulcus implantation may be required because of posterior capsular tears or because of zonular dialysis because a smaller incision is required, few or no stitches are needed and the patient's recovery time is usually shorter when using a foldable IOL.




Microphaco

In Microphaco Cataract Surgery, the incision size is generally between 1 mm to 2 mm. The cataract is removed with ultrasound technology. A probe is inserted into the eye and the ultrasound energy causes the cataract to liquify and this liquified material is suctioned out through the same probe. Generally, the probe size is around 0.9 mm. Since the eye needs a constant fluid flow and the eye pressure has to be maintained, the probe is enveloped by a silicon sleeve that allows the entry of cold balanced salt solution (BSS) into the eye for protection and to maintain the temperature of the eye.

incision