Phacoemulsification cataract extraction

Phacoemulsification cataract extraction is a relatively common way to treat cataracts. The main way to treat cataracts is still surgical treatment. The therapeutic effect of most drugs is still very small. Don’t be confused by the words used in some advertisements. For the treatment of the disease, patients can consult a regular doctor and also need to combine their own situation.

Phacoemulsification cataract extraction combines high technologies such as optics, mechanics, and electricity, and is one of the fastest growing clinical technologies in ophthalmology in the past 10 years. In the early days of phacoemulsification surgery, many ophthalmologists were daunted by serious complications such as bullous keratopathy caused by corneal decompensation. How to reduce or prevent the occurrence of this complication has attracted widespread clinical attention. The results of the study showed that the higher the energy and the longer the ultrasound time, the greater the corneal damage caused. Therefore, reducing ultrasound energy and shortening emulsification time are the most effective measures to avoid corneal complications. This has promoted the transition from dynamic phacoemulsification to suction phacoemulsification.

Indications

Generally speaking, any case suitable for extracapsular cataract extraction can undergo phacoemulsification. However, when selecting cases, relative selection criteria should be determined based on one's own technical conditions.

The following situations should be considered when making a choice:

1. It is safe to dilate the pupil to at least 6mm before surgery. Beginners should never choose cases with small pupils.

2. Cornea Complete corneal transparency is the basic condition for successful phacoemulsification. This surgery is not suitable for patients with localized corneal opacity, degeneration, or other lesions that affect corneal transparency.

3. The depth of the anterior chamber must be maintained at a sufficient depth during the operation, so patients with stubborn shallow anterior chambers should be carefully considered when selecting cases.

4. Lens nuclear hardness Beginners should choose cases with appropriate nuclear hardness. As their proficiency increases, the range of choices can be expanded.

Precautions during surgery

1. The incision must be standardized. If it is too large, it will be difficult to maintain a normal anterior chamber depth due to leakage. If it is too small, it will cause perfusion blockage, affecting the cooling of the emulsification head and the formation of the anterior chamber. If it is too far forward, it will affect the operation. If it is too far back, it may easily cause bleeding.

2. The entire operation should be performed with sufficient anterior chamber depth, and attention should be paid to protecting the corneal endothelium and pupil edge. Once the iris is sucked, the retraction function should be activated immediately to avoid pulling and continuing the operation.

3. Once the posterior capsule ruptures during the operation, emulsification should be stopped, the location and extent of the damage should be checked, and appropriate protective measures should be taken. Do not attempt to remove the prolapsed vitreous with the emulsification head.

4. Carving is an action performed under negative pressure suction conditions. Do not try to improve efficiency by compressing or pushing the lens nucleus, as this will easily cause the lens nucleus or fragments to be pressed into the vitreous cavity.