Cataract surgery for undergraduate

1. 1. Cataract SurgeryCataract Surgery What You should know By/Mohamed Ahmed El –Shafie Assistant Lecturer in ophthalmology department KafrELShiekh University
2. 2. What is a cataract? A cAtArAct is A clouding of the lens in the eye thAt Affects vision.
3. 3. How do cataracts develop? Age-related cataracts develop in two ways: 1. clumps of protein reduce the shArpness of the imAge reAching the retinA. 2. the cleAr lens slowly chAnges to A yellowish/brownish color, Adding A brownish tint to vision.
4. 4. Are there other types of cataract? • secondAry cAtArAct: glAucomA surgery, diAbetes or steroid use. • trAumAtic cAtArAct: After An eye injury, sometimes yeArs lAter • congenitAl cAtArAct. • rAdiAtion cAtArAct.
5. 5. Who is at risk for cataract? • certAin diseAses (for exAmple, diAbetes). • personAl behAvior (smoking, Alcohol use). • the environment (prolonged exposure to ultrAviolet sunlight).
6. 6. What are symptoms of a cataract? • cloudy or blurry vision. • colors seem fAded. • glAre. heAdlights, lAmps, or sunlight mAy AppeAr too bright. A hAlo mAy AppeAr Around lights. • poor night vision. • double vision or multiple imAges in one eye. • frequent prescription chAnges in your eyeglAsses or contAct lenses.
7. 7. How is a cataract detected? • visuAl Acuity test. • dilAted eye exAm. • mAgnifying lens to exAmine your retinA And optic nerve for signs of dAmAge And other eye problems. • tonometry.
8. 8. Cataract typesCataract types Nuclear sclerosis
9. 9. Posterior subscapsular
10. 10. Trauma
11. 11. Congenital (rubella)
12. 12. Intra capsular cataract extractionIntra capsular cataract extraction (ICCE)(ICCE) Management of CataractManagement of Cataract  Cryo surgery  Chemical dissolution of zonular fibers
13. 13. Indications of ICCEIndications of ICCE  Operating microscopes notOperating microscopes not availableavailable  Unstable / luxated cataractsUnstable / luxated cataracts  Week zonular supportWeek zonular support
14. 14. Management of CataractManagement of Cataract • ECCE (Extracapsular cataract extraction)ECCE (Extracapsular cataract extraction) But longer wound healing timeBut longer wound healing time
15. 15. Cataract SurgeryCataract Surgery • Small incisional PhacoemulsificationSmall incisional Phacoemulsification surgery (Developed by Kelman, USA)surgery (Developed by Kelman, USA)
16. 16. Before IOL implantation wasBefore IOL implantation was developeddeveloped • Aphakic spectaclesAphakic spectacles • Contact lensesContact lenses
17. 17. Pioneer of intraocular lensPioneer of intraocular lens implantimplant Sir Harold Ridley FRS FRCS
18. 18. 1949-1950: First IOL implants1949-1950: First IOL implants
19. 19. IOL choiceIOL choice Why foldable/injectable?Why foldable/injectable? Minimise incision size to reduceMinimise incision size to reduce healing time and astigmatismhealing time and astigmatism × PMMA(rigid) : Non-foldable+large incisionPMMA(rigid) : Non-foldable+large incision √ Acrylic: Injectable through 2.2-3.2 mm currently.Acrylic: Injectable through 2.2-3.2 mm currently.
20. 20. Phaco+IOLPhaco+IOL surgerysurgery CapsulorexisCapsulorexis
21. 21. Phaco+IOLPhaco+IOL surgerysurgery HydrodissectionHydrodissection
22. 22. Phaco+IOLPhaco+IOL surgerysurgery PhacoemulsificationPhacoemulsification
23. 23. Phaco+IOLPhaco+IOL surgerysurgery Aspiration of cortexAspiration of cortex
24. 24. Phaco+IOLPhaco+IOL surgerysurgery Foldable IOL insertionFoldable IOL insertion
25. 25. Typical injectable IOLTypical injectable IOL Superflex lens: 6.25mm x 12.50mm C-Flex lens 5.75mm x 12.00 mm
26. 26. Cflex/Superflex injector
27. 27. Loading the Superflex IOLLoading the Superflex IOL
28. 28. Superflex insertionSuperflex insertion
29. 29. Superflex insertionSuperflex insertion
30. 30. Superflex insertionSuperflex insertion
31. 31. Cataract surgeryCataract surgery Postoperative managementPostoperative management Eye pad overnightEye pad overnight Antibiotic+steroid drops for up to one monthAntibiotic+steroid drops for up to one month Change glasses at one monthChange glasses at one month
32. 32. Complications of cataractComplications of cataract surgery (many!)surgery (many!) • Posterior capsular rupture and vitreousPosterior capsular rupture and vitreous lossloss • Dropped nucleusDropped nucleus • IOL dislocationIOL dislocation • EndophthalmitisEndophthalmitis • Retinal detachmentRetinal detachment
33. 33. Thank you!Thank you!