CATARACT SURGERY

Reported by: Shane Ann Pedregosa BSN III-A

Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract.

A cataract is a clouding of the normally clear lens of the eye. When the lens becomes opaque, it interferes with the passage of light through the eye resulting in impaired vision.

 Cataract

symptoms

o fading

of colors, particularly the inability to see blues and purples, vision, cloudiness, halos around lights, reduced vision in bright light,

o blurred

o double

vision in one eye, need for brighter light when reading, poor night vision
eyeglass prescription changes.

o frequent

 Generally

performed by an ophthalmologist in an ambulatory setting, in a surgical center or hospital, using local anesthesia surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's transparency

During

TYPES

Phacoemulsification (Phaco) is the preferred method in most cases. It involves the use of a machine with an ultrasonic handpiece equipped with a titanium or steel tip.

 Conventional

extracapsular cataract extraction (ECCE): It involves manual expression of the lens through a large (usually 1012 mm) incision made in the cornea or sclera. -may be indicated for patients with very hard cataracts or other situations in which phacoemulsification is problematic.

Intracapsular cataract extraction (ICCE) involves the removal of the lens and the surrounding lens capsule in one piece. The procedure has a relatively high rate of complications due to the large incision required and pressure placed on the vitreous body.

 Intraocular

lens implantation: After the removal of the cataract, an intraocular lens (IOL) is usually implanted into the eye, either through a small incision (1.8 mm to 2.8 mm) using a foldable IOL, or through an enlarged incision, using a PMMA (polymethylmethacrylate) lens.

PREOPERATIVE EVALUATION
The

degree of reduction of vision due, at least

in large part, to the cataract should be evaluated.

The
The

eyes should have a normal pressure

pupil should be adequately dilated using

eyedrops

OPERATION PROCEDURES
Anaesthesia, Exposure of the eyeball using a lid speculum, Entry into the eye through a minimal incision (corneal or scleral) Viscoelastic injection to stabilize the anterior chamber and to help maintain the eye pressurization Capsulorhexis Hydrodissection pie Hydro-delineation Ultrasonic destruction or emulsification of the cataract after nuclear cracking or chopping (if needed), cortical aspiration of the remanescent lens, capsular polishing (if needed) Implantation of the artificial IOL Entration of IOL (usually foldable) Viscoelastic removal Wound sealing / hydration (if needed).

COMPLICATIONS
Glaucoma refers to a category of eye disorders often associated with a dangerous buildup of internal eye pressure (intraocular pressure or IOP), which can damage the eye's optic nerve that transmits visual information to the brain.

SIGNS AND SYMPTOMS

Glaucoma

often is called the "silent thief of sight," because most types typically cause no pain and produce no symptoms until noticeable vision loss occurs.
But

with acute angle-closure glaucoma, symptoms that occur suddenly can include blurry vision, halos around lights, intense eye pain, nausea and vomiting.

TYPES
Primary

open-angle glaucoma (POAG). This common type of glaucoma gradually reduces your peripheral vision without other symptoms. By the time you notice it, permanent damage already has occurred.

 Angle-closure

glaucoma. Angle-closure or narrow-angle glaucoma produces sudden symptoms such as eye pain, headaches, halos around lights, dilated pupils, vision loss, red eyes, nausea and vomiting.

Retinal detachment is a disorder of the eye in which the retina peels away from its underlying layer of support tissue. Initial detachment may be localized, but without rapid treatment the entire retina may detach, leading to vision loss and blindness. It is a medical emergency.

TYPES

Rhegmatogenous

retinal detachment occurs due to a hole, tear, or break in the retina that allows fluid to pass from the vitreous space into the subretinal space between the sensory retina and the retinal pigment epithelium.

 Exudative,

serous, or secondary retinal detachment An exudative retinal detachment occurs due to inflammation, injury or vascular abnormalities that results in fluid accumulating underneath the retina without the presence of a hole, tear, or break. retinal detachment A tractional retinal detachment occurs when fibrovascular tissue, caused by an injury, inflammation or neovascularization, pulls the sensory retina from the retinal pigment epithelium.

Tractional

SIGNS AND SYMPTOMS

flashes

of light (photopsia) very brief in the extreme peripheral (outside of center) part of vision a sudden dramatic increase in the number of floaters a ring of floaters or hairs just to the temporal side of the central vision a slight feeling of heaviness in the eye

CATARACT SURGERY RECOVERY

During at least the first week of your recovery, it is essential that you avoid: Strenuous activity and heavy lifting (nothing over 25 pounds). Bending, exercising and similar activities that might stress your eye while it is healing. Water that might splash into your eye and cause infection. Keep your eye closed while showering or bathing. Also, avoid swimming or hot tubs for at least two weeks. Any activity (such as changing cat litter boxes) that would expose your healing eye to dust, grime or other infection-causing contaminants.