Most popular procedure for senile cataract: March 2011
Ans. C: Phacoemulsification with intraocular lens implantation Phacoemulsification is today the most popular method worldwide and has now viually replaced all other techniques in most countries Phacoemulsification It refers to modern cataract surgery in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Phacoemulsification surgery involves the use of a machine with microprocessor-controlled fluid dynamics. The phaco probe is an ultrasonic handpiece with a titanium or steel needle. The tip of the needle vibrates at ultrasonic frequency to sculpt and emulsify the cataract while the pump aspirates paicles through the tip. In some techniques, a second fine steel instrument called a "chopper" is used from a side po to help with chopping the nucleus into smaller pieces. The cataract is usually broken into two or four pieces and each piece is emulsified and aspirated out with suction. The nucleus emulsification makes it easier to aspirate the paicles. After removing all hard central lens nucleus with phacoemulsification, the softer outer lens coex is removed with suction only. An irrigation-aspiration probe or a bimanual system is used to aspirate out the remaining peripheral coical matter, while leaving the posterior capsule intact. As with other cataract extraction procedures, an intraocular lens implant (IOL), is placed into the remaining lens capsule. For implanting a PMMA IOL, the incision has to be enlarged. For implanting a foldable IOL, the incision does not have to be enlarged. The foldable IOL, made of silicone or acrylic of appropriate power is folded either using a holder/folder, or a proprietary inseion device provided along with the IOL. It is then inseed and placed in the posterior chamber in the capsular bag (in-the-bag implantation). Sometimes, a sulcus implantation may be required because of posterior capsular tears or because of zonular dialysis. Because a smaller incision is required, few or no stitches are needed and the patient's recovery time is usually shoer when using a foldable IOL
lntracapsular cataract surgery with intraocular lens implantation
Extracapsular cataract surgery with intraocular lens implantation
Phacoemulsification with intraocular lens implantation
Lensectomy and IOL implantation