Cataract Surgery- Dr. Murali Mohan Gurram

7/28/2019 Cataract Surgery- Dr. Murali Mohan Gurram

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Eye Education Series-Cataract Surgery: Dr. Murali Mohan Gurram

Script by Dr. Murali Mohan Gurram Page 1

CATARACT SURGERY What every patient should know

Cataract

Our eye is like a camera. A camera has a group of lenses to zoom and focus the image. The same

job in human eye is done by a single structure called asLens. This lens is placed behind the irisand helps in focusing and zooming the images.

This lens is a clear structure which is placed in a bag called asCapsular bag similar to a toffee

being wrapped tightly by a plastic paper. But this capsular bag has no free ends. This lens is

suspended behind the iris.

In old age due to many bodily changes, this lens slowly starts losing its transparency. This

opacification of lens is called asCataract. Since cataract is a disorder of old age, every individual

has to face it in old age.Cataracts commonly affect both eyes, but it is not uncommon for

cataracts in one eye to advance more rapidly.Typical symptoms may include blurry vision, glare,

difficulty with night vision, poor color vision, or frequent changes in eyeglass prescription.

Fig. 1

Cataract surgery

There is no medical treatment for cataract. Surgery is the only treatment available. Cataractsurgery is the most commonly performed surgery in the world. I t has 98 percent success rate.

With the advancements in surgical fields, now, a cataract surgery can be done without injection

(needle prick), within a few minutes with Phaco. The patient can resume his duties on the same

day of surgery.


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Cataract surgery is performed to replace the opaque natural lens (cataract) with an artificial lens

which is called as Intra-Ocular Lens (IOL). As said earlier, the lens is placed in capsular bag

which has no free openings. To reach the lens, we need to make an opening in the surface of the

bag. This is called capsulotomy. Through this opening, the lens is removed, leaving an empty

bag. An artificial lens (IOL, IntraOcular Lens) is placed in this bag, which now starts doing thejob of original lens. To reach the capsular bag, we need to make an opening in the eyeball, which

is called as incision. Through this incision we reach the capsular bag, make an opening in the

bag (capsulotomy), remove the lens and insert an IOL in the bag. Briefly, these are the steps of

surgery. Since the structures of eye are very small, a microscope is used to magnify the image.

Therefore its a microscopic surgery and requires utmost care and skill.

Surgical Techniques

There are many surgical techniques based on the different approaches in either of above

mentioned steps. The incision can be placed on sclera or limbus or cornea (Fig.2). Corneal

incision is the most preferred as it has least tissue manipulation. The size of incision can varyfrom a large 12 mm to less than 2 mm size. The lesser the size, the lesser the tissue

manipulation and healing time and recovery time. A large incision may need stitches to close it,

while smaller ones do not need stitches. Stitches should best be avoided as they cause redness,

discomfort and watering. The removal of lens can be done manually which requires a large

incision, or it can be done with Phaco with very small incision. Phaco is a technique where in a

needle is passed into the lens, which dissolves the lens with ultrasound energy and sucks the lens.

Phaco is the best and the most ideal technique of cataract surgery.


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Fig. 4


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While cataract surgery is one of the safest procedures available with a high rate of success, rarecomplications can arise. The most common problems arising after surgery are persistentinflammation, changes in eye pressure, infection, or swelling of the retina at the back of the eye,and retinal detachment. If the capsular bag is injured, then the artificial lens may need to beplaced in a different location. In very rare cases, the intraocular lens moves or does not function

properly and may need to be repositioned, exchanged, or removed. All of these complicationsare extremely rare but can lead to significant visual loss if left untreated; thus, close follow-up isrequired after surgery.

Fig. 6

(Thanks for google images for providing me the sources of images)


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Cataract Surgery- Dr. Murali Mohan Gurram

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