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Cataract Surgery Techniques Guide

This document describes different techniques for managing senile cataracts. It compares conventional extracapsular cataract extraction (ECCE), manual small incision cataract surgery, and phacoemulsification. Conventional ECCE involves making a larger incision and removing the anterior capsule, nucleus, and cortex. Manual small incision surgery uses a smaller incision of 5.5-7.5mm. Phacoemulsification uses the smallest incisions from 1-3.5mm. All techniques involve making an incision, removing the lens material, and implanting an intraocular lens.

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NIRANJAN KALE
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222 views11 pages

Cataract Surgery Techniques Guide

This document describes different techniques for managing senile cataracts. It compares conventional extracapsular cataract extraction (ECCE), manual small incision cataract surgery, and phacoemulsification. Conventional ECCE involves making a larger incision and removing the anterior capsule, nucleus, and cortex. Manual small incision surgery uses a smaller incision of 5.5-7.5mm. Phacoemulsification uses the smallest incisions from 1-3.5mm. All techniques involve making an incision, removing the lens material, and implanting an intraocular lens.

Uploaded by

NIRANJAN KALE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Management of Senile

Cataract
Entire cataractous lens along with lens capsule is removed

PREREQUISITE: WEAK AND DEGENERATES


ZONULES

Age -40 -50 yr of age by use of enzyme alphachymotrypsin

Indication: Subluxated and dislocated lens


Extracapsular cataract extraction
Major portion of anterior capsule with epithelium, nucleus and co
removed,Leaving behind intact posterior capsule
Types of ECCEConventional extracapsular cataract extraction :7-8 m
small incision cataract surgery:[Link]: 3 to
Microincisin : 2mmPhaconit: 1mm
[Link] ECCE
Superior Rectus (bridle suture)

Conjunctival flap

Partial thickness groove/gutter

Corneoscleral section

injection of viscoelastic substance in


anterior chamber: 2% methyl
cellulose Or1% Sodium hyaluronate
Anterior Capsulotomy: Staining required so Dye used : Trypan
Blue dye
Two technique
[Link] opener technique
[Link] circular CapsulotomyRemoval of anterior capsule

Irrigating solution: Basal salt solution with glutathione

Hydrodissection:It is injecting irrigating fluid between


posterior capsule and cortex

Hydrodelineation: used to separate epinucleus and


endonucleus

Hydrodelineation: used to separate epinucleus and


endonucleus
Aspiration of cortex

Implantation of IOL

Closure of incision:
3-5 Radial
interrupted sutures

Subconjunctival
injection and
Patching of eye
B) MANUAL SMALL INCISIONAL
CATARACT SURGERY
Superior Rectus suture

Conjunctival flap and


exposure of sclera

Haemostasis: Diathermy /
Electric/ thermal cautery
Sclerocorneal tunnel
incision
5.5 to 7.5 mm and
sclerocorneal
tunnel:1 to 1.5 mm
small
Side portal entry-
Hydrodissection

Nuclear management

a) prolapse of nucleus
b)Delivery of nucleus
through corneal sclero tunnel

Aspiration of Cortex
IOL implantation
Wound closure: 3-5 suture
PHACOEMULSIFICATION
Corneoscleral incision
Very small 3-3.5 mm
Micro incision: 2 mm
Phaconit:1mm

Viscoelastic substance : in anterior chamber


Hydroxy propyl methyl cellulose

Dye: Trypan blue

Capsulorhexis :
Nick at anterior capsule

Hydrodissection and hydrolineation


Golden ring : indicates Good hydrodissection and hydrodelineation
Nucleotomy

IOL insertion.... Photo


Folded IO

No sutures required , hydrating wound


with Basal salt solution

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