Cataract surgery is the taking out of natural lens (also known as “crystalline lens) of an eye. When natural lens function is deteriorated due to the development of opacification, it is removed. With the age, due to the metabolic changes in crystalline lens fibers Cataract, there develops cataract in the eye which causes impairment of vision, loss of transparency and even lost of vision. Early symptoms of it include small light sources at night and powerful frown from light. Through laser cataract surgery the effected or malfunctioning lens is removed and at its place a synthetic lens is inserted; and lens’s transparency is restored.
An ophthalmologist performs laser cataract surgery in surgical and hospital settings. He uses local anesthesia, either it can be topical and peribulbar or retrobulbar. The operation causes no pain to the patient. More than 90 per cent of the operations go successful and the patient gets back their correct vision. Complication rate is low. Laser cataract surgery offers day care, minimum invasion, small incision phacoemulsigication and quick recovery after operation. Hence it has become a standard of care all over the world in cataract surgery.
Laser cataract surgery is performed in three ways as discussed bellow.
In most of the cases Phacoemulsificaiton is used. In this method an ultrasonic hand piece machine is used. It has a titanic or steel tip. Tip of the hand piece vibrates with a frequency of 40,000 Hz and thus it emulsifies the natural lens. A cracker or chopper is then used to assist the process of emulsification since it is easier to remove the fragmented parts. When the phacoemulsification is completed a bimanual I-A or a dual irrigation aspiration I_A process helps to aspirate out the rest of peripheral cortical material.
Another method for laser cataract surgery is Extracapsular cataract extraction (ECCE). The process includes the removal of the whole natural lens but the posterior capsule (also known as elastic lens capsule) is allowed to stay intact, so that it may allow implanting a new intraocular lens. Large incision usually of 10-12 mm in the sclera and cornea is required. The process involves very much perfection at the side of medical men as there is a use of stitches. This is conventional method of laser cataract surgery and is not usually recommended. But it is advised to avoid it in ordinary cases. It is only applied when the cataracts are very hard or when there is some problem in the use of phacoemulsification.
Another type of laser cataract surgery is intracapsular cataract extraction (ICCE). The process differs from the other two in a way that in it the natural lens is removed in one piece. After removing the lens, a new lens is placed either in sulcus or in interior chamber. The process requires extraordinarily precision as in it the medical man has to manage the pressure on vitreous body. Thus the procedure is not often recommended but to avoid it is advised. The operation is carried on only in the countries which have high technology equipment and very precisely working microscopes are readily available.