Intracapsular cataract extraction (ICCE): A large incision is made to cut the corneoscleral rim, and after entry, the crystal is frozen with a freezing tip and pulled outward to cause rupture of the suspensory ligament and delivery of the crystal.
Extracapsular cataract extraction (ECCE): a switching capsule is truncated and the lens is delivered.
Phaco: continuous ring tearing of the capsule, ultrasonic emulsification of the crystal nucleus, perfusion and aspiration of the crystal cortex, implantation of IOL
Cataract ultrasonic emulsification technology
Cataract ultrasonic emulsification technology is a major achievement of microsurgery, since 1967, Dr. Kelman of the U.S. invented the first ultrasonic emulsification instrument and used in clinical practice, after 30 years of many ophthalmologists. Since Dr. Kelman invented the first ultrasonic emulsification machine in 1967 and used it in the clinic, and after 30 years of continuous improvement by many ophthalmologists, cataract ultrasonic emulsification has become a world-recognized, advanced and mature surgical method. Ultrasonic emulsification has been popularized in developed countries and has been introduced and promoted in China since 1992. During the surgery, an ultrasonic probe is inserted into a small incision in the cornea or sclera of the eye to break up the cloudy lens and cortex into chalcogenide, and then the chalcogenide is sucked out with the help of a suction-irrigation system to keep the anterior chamber full, and then an artificial lens is implanted to give the patient back his/her sight. Ultrasonic emulsification technology truly realizes the surgical ideal of small incision, no pain, short operation time, no need for hospitalization, and rapid restoration of sight.
What are the characteristics of cataract IOL implantation
Compared with the traditional surgery, cataract IOL implantation has the following advantages:
1. The incision is small, the traditional surgical incision is 12MM, and the incision of the surgery is less than 3MM.
2. The postoperative reaction is mild, the incision heals quickly, and the vision recovery is faster and better.
3. Astigmatism is small and easier to correct or control after surgery.
4. Better surgical control, safety and stability.
5. Surgery time is short, usually about 15-30 minutes.
6. There is no need for hospitalization, and you can go home one hour after surgery.
7. There is no need to wait for the cataract to mature before performing the surgery.
Why to install IOL after cataract removal
After cataract removal, the eye loses the essential structure of the lens, and vision is still not clear, and there are many drawbacks or shortcomings of wearing glasses without lens (frame) and corneal contact lenses, so the most ideal method is to install an IOL, so that the vision and field of view will be restored to normal. Under normal circumstances, the implanted IOLs can last a lifetime.
Cataract Surgery Lens Options
Monofocal IOL: This is the most commonly used IOL, which can improve nearsightedness or farsightedness, and is suitable for any people, but it only has a single focal length, and can only provide the function of looking at the distance or looking at the near. If a monofocal IOL is implanted for distance vision, the patient can see clearly at a distance, while presbyopia glasses are required for near activities such as reading or playing cards. [1]
Adjustable IOLs: Suitable for cataract patients who are relatively young, the IOLs can see objects at any distance clearly as the eyeball relies on the contraction of the ciliary muscles to image objects clearly in the retina, allowing the patient to see things clearly from far away to near, and most of the people can be free of presbyopia glasses after the surgery. [1]
Trifocal IOL: Suitable for people with presbyopic cataract who pursue high quality of life, it is a high-end functional IOL with full range of vision at distance, intermediate, and near, and it has 100% satisfaction in near and distance vision. With good night vision, you can read, drive, work, etc. at night without wearing glasses to have perfect full vision. Advantages: Have true intermediate vision, reduced glare, no need to rely on pupils, very little glare even in dim light conditions, no chromatic aberration, can correct chromatic aberration on its own. [1]Preoperative examination for cataract surgery
Most cataract patients are old and frail, with a variety of systemic comorbidities, so in order to make the surgery successful and prevent complications, some necessary local and systemic examinations should be performed before the surgery.
1. Routine examination
The eye examination before cataract surgery should include visual function (light perception, light localization, color vision). Routine slit lamp examination of the eye, intraocular pressure measurement. For suspected fundus lesions, visual electrophysiologic examination, ultrasound examination of the eye, macular function examination. For those who have had eye surgery, corneal endothelial cell count can be done as needed.
Based on the above examinations, the condition of the eye to be operated on can be evaluated, the recovery of visual function after the operation can be estimated, and the possible complications and risk factors during the operation can be prepared for.
There are no specific rules for the timing of cataract surgery. In the past, it was believed that cataracts should be operated only after they were mature, but with the development of surgical techniques, immature cataracts can also be treated surgically. For those patients with nuclear cataracts that require high visual acuity, surgery can also be arranged for those with visual acuity of 0.3 or 0.5 or more.
2. Examination of special patients
The timing, mode or order of surgery should be carefully decided for patients who have eye diseases at the same time. For example, those with chronic dacryocystitis should first undergo nasal dacryocystostomy or dacryocystectomy, and those with glaucoma may be considered for combined glaucoma-cataract surgery.
For patients with cardiovascular disease should be controlled before surgery; if possible, cardiac monitoring during the operation to ensure the safety of the operation.
For patients with diabetes mellitus, blood sugar should be controlled first, and antimicrobials should be applied before surgery to prevent infection. In the systemic or local acute and chronic inflammatory lesions should be treated first.
Pre-operative precautions
1. If you have high blood pressure, diabetes, or cough, you should consult a physician for diagnosis and treatment, and wait until your condition is stabilized before performing cataract surgery.
2. If you are taking medication for high blood pressure, diabetes or cough, please continue to take it before, during and after the surgery.
3. Do your personal hygiene (shampooing and bathing) the day before surgery.
4. On the day of surgery, please clean your face and do not use any cosmetics.
5. You can eat a small amount of food before surgery.
6. You must be accompanied by your family on the day of surgery.
7.