OPHTHALMIC OPERATION 6 Cataract extraction

Cataract Extraction

Objective

In cases of impaired vision due to opaque lens:

•   The removal of an ‘opaque’ crystalline lens.

•   To replace it with an intraocular lens. To restore vision

Position

Supine.

Anesthesia

Local retrobulbar and facial nerve injection.

Procedure

   1.  Insertion of an eye speculum.

   2.  Traction suture is inserted through the belly of the superior rectus muscle.

   3.  The conjunctiva is incised above the limbus.

   4.  A flap of conjunctiva is reflected over the limbus.

   5.  Incisions are made in the limbus.

   6.  Synthetic absorbable stay-stutures are inserted to facilitate closure of the corneal flap.

   7.  The anterior chamber is then irrigated with saline to remove traces of enzymes.

   8.  Extraction of the lens.

   9.  After cataract operations the surgeon may insert a plastic lens implant.

10.  The corneoscleral incision is closed with synthetic absorbable sutures.

11.  The conjunctival incision is closed.

Instruments

•   Anterior segment set

•   Cataract set

•   Diamond knife or razor fragment in holder

•   Eyelid retractors (Desmarre), 2

•   Capsule forceps (Arruga or McPherson)

•   Iris repositor (Bowman)

•   Razor fragment in holder

•   Angled corneal splitter (Tooke)

•   Corneal scissors (Troutmans)

•   Anterior chamber cannula (Ryecroft) with irrigator (Southamptom) for Chymar, Trypsin, Zonulysin (to digest suspensory ligaments)

•   Cryoprobe and cryomachine

•   1 (4) Synthetic nonabsorbable or white silk on small half-circle cutting needle for traction sutures

•   0.5 (8/0) Synthetic nonabsorbable or virgin silk on small curved cutting needle for corneoscleral and conjunctival sutures

•   0.2 (10/0) Synthetic nonabsorbable on small micro point needle for implant fixation

•   Corneal splitter (Tooke)

•   Veetis (Knolle)

•   Fine needle holder (Castroviejo) (Fig. 14.48).

Any questions be sent to drmmkapur@gmail.copm

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