Before the advent of phacoemulsification by the late Dr. Charles Kellman in the 1970’s, cataract surgery was a big deal. It involved making a large (12mm) incision with subsequent removal of the whole cataract from the eye. The removal of a cataract in toto was termed extracapsular cataract extraction, and was akin to removing a pit from a cherry. This surgery was associated with a lengthy post operative recovery as the large incisions required lots of stitches. The stitches caused high degree of post operative astigmatism, necessitating strong glasses prescriptions.
The unrelenting progress of science and technology has lead to development of phacoemulsification, clear corneal microincisions (less than 2mm), that are self sealing and require no stitches. The lens technology has advanced to where a foldable lens is inserted through the microscopic opening.
All this means that in capable hands, cataract extraction takes 5 to 7 minutes, with the patient enjoying greatly improved vision almost instantaneously in recovery room.
Step 1: Anesthetic and dilating eye drops are instilled
Step 2: The eye is anesthetized and the pupils are dilated
Step 3: A clear corneal self sealing micro incision is made
Step 4: A round opening in the capsule containing the lens is made
Step 5: This opening, termed a capsulotomy, is continued
Step 6: A small opening, termed a capsulotomy is made in the capsule containing the cataract
Step 7: Anesthetic and dilating eye drops are instilled
Step 8: The eye is anesthetised and the pupils are dilated
Step 9: A clear corneal selfsealing micro incision is made: an ultrasonic probe is used to break up and vacuum the cloudy lens.
Step 10: A clear corneal micro incision is made
Step 11: A foldable lens implant is injected into the eye, where it unfolds gently, like a flower
Step 12: The incision is self-sealing and requires no stitches or glue
In good hands nothing has been proven to be safer and more effective than the small incision phacoemulsification with ultrasound demonstrated above.
Recently a completely new method of cataract extraction has come on line. The Femtosecond Laser Assisted Cataract Extraction. You can learn more about this revolutionary new technology currently available at the Benjamin Eye Institute.
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