Why Need a Phacoemulsification & Its Benefits
Phacoemulsification is a cataract removal surgery that involves taking out the front portion of the eye lens while retaining the posterior capsule. It is a safe, painless procedure followed by the implantation of an artificial lens (IOL) in the affected eye to improve vision.
Eye cataract is the clouding of the eye’s natural lens, leading to considerable vision loss especially among people beyond the age of 40. There are several types of cataracts, classified according to the location where it occurs. Clouding at the back portion of the lens is termed a subscapular cataract, while the one that forms in the nucleus of the lens is called a nuclear cataract. A cortical cataract, on the other hand, starts at the periphery of the lens and spreads inwards toward the center. To some degree, the formation of cataract is related to aging, though more and more people are afflicted with it due to diseases and other medical conditions.
The technique by which cataract is broken into small pieces and removed from the eye using ultrasound with the help of a special phaco equipment is needed a great phaco training. The actual cataract operation is carried out through a 2.5 to 2.8 mm incision with the help of a titanium needle vibrating at the rate of more than 40,000 times per second.
In early days routine cataract operation is carried out through an incision which is 8 to 10 mm in length through which the first cataract is removed and then an intraocular lens is implanted. In the Phacoemulsification technique, cataract removal is done through 2.5 mm to 2.8 mm opening only ( maximum it is extended to 5 mm) for implantation of the intraocular lens and this avoids the necessity for stitches to close the wound and reduce the number of glasses required for distant vision. Very rarely only a single stitch may be needed.
Who Should Undergo
Patients with cataracts are advised to undergo phacoemulsification, especially those who need to maintain good visual acuity for driving, flying, or operating machinery and equipment. The procedure is safe and can be performed on patients of all ages, including infants with congenital cataract and older individuals.
Patients who are at a higher risk of developing cataract can also consider the procedure. These include diabetic, hypertensive, and obese patients as well as those who experienced injury and trauma to the eye that resulted in cloudy or hazy vision.
Phacoemulsification has a high success rate, with patients reporting improved vision and the ability to perceive color and depth more accurately following the procedure. In a large study, 95 out of 100 adult patients were satisfied with the results reporting increased mobility and independence and relief from the fear of going blind. Those who were not happy with the results had other existing eye problems such as macular degeneration and glaucoma.
How is the Procedure Performed?
Prior to the procedure, the patient is subjected to a complete eye exam where the ophthalmologist uses ultrasound or laser scanning device to check the affected eye thoroughly. The tests are meant to determine the best IOL for the patient.
Phacoemulsification is an outpatient procedure that can be performed either under local (adult patients) or general anesthesia (pediatric patients). Using a microscope, the surgeon makes a small incision in the eye, at the side of the cornea. A viscoelastic fluid is then injected to cushion the intraocular tissue and reduce shock. Another incision is made in the membrane surrounding the cataract so it can easily be separated from the cortex using water stream. A titanium needle called a phaco probe is then inserted into the cornea and directed into the central nucleus of the cataract where it is most dense. This device oscillates at great speed to break up the cataract into minute pieces, which are then suctioned by a small hole at the tip of the probe. As the central core of the cataract is emulsified and removed, the probe moves into the peripheral part of the lens and the front part of the lens capsule is removed, as well as some part of the natural lens. A folded intraocular lens is then implanted into the capsule bag using an injector and unfolded in place. This permanent implant replaces the front portion of the natural lens while the remaining back portion of the lens holds the inserted lens in place. The viscoelastic fluid introduced at the start of the procedure is then removed.
Phacoemulsification can also be performed using laser technology. This method involves the use of a specialized machine that makes the incision and softens the cataract so it can be easily removed. The procedure follows the same method as traditional phacoemulsification but since laser technology is used instead of a knife, it offers quicker recovery time and is more accurate.
Depending on the technique used, the incisions may be closed with very small stitches or self-sealing method is performed. Patients with stitches are scheduled for a follow-up for the removal of the said sutures.
The surgery lasts about an hour and can only be performed one eye at the time. Patients with cataracts in both eyes are typically scheduled for cataract removal sessions that are spaced two weeks apart.
Benefits of Phaco surgery:
1)No hospitalization - Walk in, Walk out surgery.
2)Smaller incision- hence lesser complications related to the incision size.
3)Lesser induced astigmatism because of a smaller incision.
4)No bandages minimal precautions.
5)No restriction on normal activities. Can join work from the next morning.
6)Fast recovery of good vision in a matter of days.
7)Final spectacles at one or two weeks.
8)Early visual rehabilitation.
Eye cataract is the clouding of the eye’s natural lens, leading to considerable vision loss especially among people beyond the age of 40. There are several types of cataracts, classified according to the location where it occurs. Clouding at the back portion of the lens is termed a subscapular cataract, while the one that forms in the nucleus of the lens is called a nuclear cataract. A cortical cataract, on the other hand, starts at the periphery of the lens and spreads inwards toward the center. To some degree, the formation of cataract is related to aging, though more and more people are afflicted with it due to diseases and other medical conditions.
The technique by which cataract is broken into small pieces and removed from the eye using ultrasound with the help of a special phaco equipment is needed a great phaco training. The actual cataract operation is carried out through a 2.5 to 2.8 mm incision with the help of a titanium needle vibrating at the rate of more than 40,000 times per second.
In early days routine cataract operation is carried out through an incision which is 8 to 10 mm in length through which the first cataract is removed and then an intraocular lens is implanted. In the Phacoemulsification technique, cataract removal is done through 2.5 mm to 2.8 mm opening only ( maximum it is extended to 5 mm) for implantation of the intraocular lens and this avoids the necessity for stitches to close the wound and reduce the number of glasses required for distant vision. Very rarely only a single stitch may be needed.
Who Should Undergo
Patients with cataracts are advised to undergo phacoemulsification, especially those who need to maintain good visual acuity for driving, flying, or operating machinery and equipment. The procedure is safe and can be performed on patients of all ages, including infants with congenital cataract and older individuals.
Patients who are at a higher risk of developing cataract can also consider the procedure. These include diabetic, hypertensive, and obese patients as well as those who experienced injury and trauma to the eye that resulted in cloudy or hazy vision.
Phacoemulsification has a high success rate, with patients reporting improved vision and the ability to perceive color and depth more accurately following the procedure. In a large study, 95 out of 100 adult patients were satisfied with the results reporting increased mobility and independence and relief from the fear of going blind. Those who were not happy with the results had other existing eye problems such as macular degeneration and glaucoma.
How is the Procedure Performed?
Prior to the procedure, the patient is subjected to a complete eye exam where the ophthalmologist uses ultrasound or laser scanning device to check the affected eye thoroughly. The tests are meant to determine the best IOL for the patient.
Phacoemulsification is an outpatient procedure that can be performed either under local (adult patients) or general anesthesia (pediatric patients). Using a microscope, the surgeon makes a small incision in the eye, at the side of the cornea. A viscoelastic fluid is then injected to cushion the intraocular tissue and reduce shock. Another incision is made in the membrane surrounding the cataract so it can easily be separated from the cortex using water stream. A titanium needle called a phaco probe is then inserted into the cornea and directed into the central nucleus of the cataract where it is most dense. This device oscillates at great speed to break up the cataract into minute pieces, which are then suctioned by a small hole at the tip of the probe. As the central core of the cataract is emulsified and removed, the probe moves into the peripheral part of the lens and the front part of the lens capsule is removed, as well as some part of the natural lens. A folded intraocular lens is then implanted into the capsule bag using an injector and unfolded in place. This permanent implant replaces the front portion of the natural lens while the remaining back portion of the lens holds the inserted lens in place. The viscoelastic fluid introduced at the start of the procedure is then removed.
Phacoemulsification can also be performed using laser technology. This method involves the use of a specialized machine that makes the incision and softens the cataract so it can be easily removed. The procedure follows the same method as traditional phacoemulsification but since laser technology is used instead of a knife, it offers quicker recovery time and is more accurate.
Depending on the technique used, the incisions may be closed with very small stitches or self-sealing method is performed. Patients with stitches are scheduled for a follow-up for the removal of the said sutures.
The surgery lasts about an hour and can only be performed one eye at the time. Patients with cataracts in both eyes are typically scheduled for cataract removal sessions that are spaced two weeks apart.
Benefits of Phaco surgery:
1)No hospitalization - Walk in, Walk out surgery.
2)Smaller incision- hence lesser complications related to the incision size.
3)Lesser induced astigmatism because of a smaller incision.
4)No bandages minimal precautions.
5)No restriction on normal activities. Can join work from the next morning.
6)Fast recovery of good vision in a matter of days.
7)Final spectacles at one or two weeks.
8)Early visual rehabilitation.
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