Types of Cataract Surgery

Cataract surgery is the removal of the lens of the eye, when it develops an opacification, known as cataract. Cataract is caused due to metabolic changes in the crystalline lens fiber of the eye. A cataract surgery is performed by an ophthalmologist, wherein he removes the natural lens and implants an artificial intraocular lens in its place. The cost of cataract surgery is largely dependent on a number of factors, such as the type of replacement lens used, the type of cataract and so on. Though there are various methods of performing the cataract surgery, mostly two of them are commonly conducted in countries around the globe. To get detailed information about all the four types of cataract surgery, read through the following lines.

The most preferred method out of the four, this type of surgery involves usage of machine with an ultrasonic hand piece, equipped with a titanium or steel tip. With an ultrasonic frequency of 40,000 Hz, the titanium or steel tip starts vibrating, in turn blending the lens material. At times, a second fine instrument, called a cracker or chopper, might also be used. It is brought in use from a side port, in order to enable the cracking or chopping of the nucleus, turning them into smaller pieces. This in turn, helps in making the process of emulsification easier and also the aspiration of cortical material. Once the phacoemulsification of the lens nucleus and cortical material is done, a dual irrigation-aspiration (I-A) probe or a bimanual I-A system is used. This is mainly done to aspirate out the remaining peripheral cortical material.

 

If the cataract of the patient has reached a stage, where it cannot be removed with Phacoemulsification, then Extracapsular cataract surgery is conducted. The process involves manual expression of the lens through 10 to 12 mm incision made in the cornea or sclera. The procedure requires large incision and usage of stitches. Microincision cataract surgery involves a technique by which a cataract can be reached through an incision of 1.5 millimeters or less.

 

A third type of cataract surgery which is quickly picking up is the Small Incision Cataract Surgery or SICS. In this procedure, though the incision made is large, it is still small in comparison with the conventional method of ECCE. The incision made is about 5-6 mm and the cataract is removed using fluid pressure. There are no stitches required in the process and the patient recovers fast.

 

The process of Intracapsular Cataract Extraction (ICCE) entails the removal of the lens and the surrounding lens capsule in one piece. There is a high rate of complication in the process and it requires application of pressure on the vitreous body. After lens removal, an artificial plastic lens is either placed in the anterior chamber or sutured into the sulcus. Too much complication is the only reason for the rare popularity of this method. ICCE is only performed in countries where operating microscopes and high-technology equipment are readily available.