II. Definition
- Surgical removal of lens
III. Indication: Visual Impairment secondary to Cataract
- Prevents Activities of Daily Living (ADL)
- Significantly interferes with patient's life-style
IV. Efficacy
V. Preparation
- Preoperative exam
- Medical conditions stable
- No current infectious disease
- No current Skin Infections
- Medication history of any Alpha Adrenergic Antagonists
-
Topical Antibiotic used preoperatively
- Cleanses the lids
VI. Technique: General
- Outpatient 1 hour procedure under Local Anesthesia
- Techniques
- Extracapsular (95%)
- Lens nucleus removed through anterior lens capsule
- Phacoemulsification used on younger patients
- Soft lens fragmented with Ultrasound
- Lens components aspirated
- Phacoemulsification used on younger patients
- Posterior lens capsule polished and left intact
- Causes less derangement of surrounding tissue
- Provides chassis for new lens implant
- Lens nucleus removed through anterior lens capsule
- Intracapsular
- Older technique, used up until the mid 1980's
- Entire lens and capsule removed
- Lens frozen to cryoextractor tip and removed
- Extracapsular (95%)
VII. Technique: Lens Replacement
- Background
- Types
- Intraocular lens Implant (95%)
- Implanted at time of Cataract surgery
- Lens implant can be delayed years after surgery
- Contact Lenses
- Difficult to handle for many elderly
- Requires sufficient eye tearing
- Aphakic Spectacles (least desirable)
- Intraocular lens Implant (95%)
VIII. Precautions: Floppy Iris Syndrome
- See Floppy Iris Syndrome
- Current or prior use of Alpha Adrenergic Antagonists can have a significantly increased risk of intraoperative complications
IX. Management: Postoperative follow-up
- Ophthalmology follow-up:
- 24 hours after surgery
- 2-4 days after surgery
- Periodic exams until lens prescribed at 2-3 months
- Urgently for change in eye appearance or Sensation
- Precautions
- Avoid Eye Trauma
- Avoid Increased Intraocular Pressure
- Strenuous Physical Activity
- Bending
- Use eye-shields or glasses all the time
- Management
- Eye patch
- Worn continuously for first week after surgery
- Worn only at night After first week
- Activities
- After first week, normal activities performed
- Patient may drive after first week if Vision ok
- Medications
- Topical Antibiotic and steroid for first 3-4 weeks
- Suture
- Small enough (10-0 nylon) to not require removal
- Suture removed at 6-8 weeks if necessary
- Healing
- Completely healed by 3 months after surgery
- May obtain final Refraction at that time
- Eye patch
X. Complications (5% Incidence of major complication)
- See Floppy Iris Syndrome
- Fulminant Endophthalmitis (0.1% Incidence)
- Infection inside eye occurs within first week
- Caused by Staphylococcus and Streptococcus
- Vision Loss can occur in 24 hours (0.02% Incidence)
-
Glaucoma
- Occurs in first 4 days
- Hemorrhage
- Suture breakage
- Intraocular lens displacement
- Iritis
- Clouding of Posterior Capsule
- Occurs in up to 50% of patients
- Follows extracapsular extraction within several years
- Treated by Neodymium YAG laser
- Causes breakdown of posterior capsule
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Related Studies
Definition (MSH) | The removal of a cataractous CRYSTALLINE LENS from the eye. |
Concepts | Therapeutic or Preventive Procedure (T061) |
MSH | D002387 |
SnomedCT | 54885007, 265822000, 274013007, 148886005, 148879002 |
English | Cataract Extractions, Extractions, Cataract, Extraction, Cataract, CE - Cataract extraction, Cataract extractions, cataract extraction (treatment), cataract extraction, cataract extractions, cataract surgery, cataracts surgery, cataract surgeries, cataract excision, cataract removal surgery, Cataract extractions (procedure), Cataract extraction, Excision of cataract, Extraction of cataract (procedure), Extraction of cataract, Extraction of cataract, NOS, Excision of cataract, NOS, Cataract extraction, NOS, Cataract extraction NOS, Cataract Extraction |
Spanish | resección de catarata, Extracción de catarata, escisión de una catarata, extracción de una catarata (procedimiento), extracción de una catarata, Extracción de Catarata |
Dutch | cataractextractie, Cataractextractie, Extractie, cataract- |
French | Extraction du cristallin, Extraction de cataracte |
Italian | Estrazione di cataratta, Estrazione della cataratta |
Portuguese | Extracção de catarata, Extração de Catarata |
Japanese | 白内障による水晶体摘出, ハクナイショウニヨルスイショウタイテキシュツ, 毛様小体離断法-酵素性, 酵素的毛様小体離断法, 毛様小体離断法-酵素的, 白内障摘出, 酵素的小帯融解術, 白内障摘出術 |
Swedish | Starroperation |
Finnish | Kaihenpoisto |
Russian | FERMENTNYI ZONULOLIZ, KATARAKTY EKSTRAKTSIIA, КАТАРАКТЫ ЭКСТРАКЦИЯ, ФЕРМЕНТНЫЙ ЗОНУЛОЛИЗ |
Czech | Extrakce katarakty, extrakce katarakty, čočka oční - extrakce, extrakce oční čočky, katarakta - extrakce |
Croatian | KATARAKTA, EKSTRAKCIJA |
Polish | Usunięcie zaćmy, Zonuloliza enzymatyczna |
Hungarian | Cataracta extractio |
Norwegian | Grå stær-kirurgi, Grå stær-operasjon, Kataraktkirurgi |
German | Kataraktextraktion |