Phacoemulsification Cataract Surgery

June 19th, 2007 at 22:47 · Filed Under Days in My Life, Medical 

After more than six months of recovery from retinal detachment, finally I was scheduled for cataract removal surgery on June 12. Some unforeseen circumstances happened in the clinic and my surgery had to be postponed to June 19.

Today, I woke up early getting prepared to take the bus to Kuala Lumpur. When everyone were ready, LA took us in the car and sent me to the bus terminal at Sentral.

When I arrived at the clinic around 0900, many people were waiting at the clinic. I registered myself. My surgery was scheduled at 1400 so I had some time to check out some hotels around that area. There were some travelers’ lodges. The interior environment was not bad at all but I preferred attached bathroom and quieter environment after my surgery. I look around the area and found one hotel. Some hotels were fully occupied. Settled down in the hotel, I went for lunch and then went to Low Yat Plaza to check out some computer stuff. Nothing interesting and still had plenty of time. Bought a drink and sat down in Coffee Beans to read some newspaper while waiting.

When it was time, I left for the clinic. I was second in the queue. The first patient was a businessman from Malacca. What a coincidence! We introduced ourselves and chatted for a while. Not waiting too long, our doctor arrived and the man was told to get ready. After some 15 to 20 minutes of waiting, it was my turn to get ready. The nurse led me up the stairs and prepared me. Shortly after that, the man was out from the surgery room. His right eye was bandaged. “Is it painful?”, I asked. He replied “No. Not at all.”

Then a nurse came and took me into the surgery room. “Lay there”, she commanded friendly. I laid down on the operating table and the other male nurse covered me with a blanket. Then the female nurse covered my face with a surgical cloth exposing my right eye. Skillfully, she put on an adhesive film onto the exposing part of my face.

I could hear the doctor sat down and asked me if I was fine. “Yeah, I’m fine.”, I replied. He then with a scissor in his skillful hand, cut a hole on the film exposing only my right eye. He then told me that he was going to administer local anesthetic. I could see him holding a syringe with very fine needle. He told me not to move. Both the nurses were holding my head on both sides. I began to tense. So tense that I became as stiff as a dead log.

“Ouch!”, I cried. It was painful. I felt like he was injecting into my eyeball. Eight shots! My God! “Ouch! Ouch! Ouch!…”, I cried. After the injection, somone put a thick gauze onto my right eye and massaged with some pressure. After a while I could feel numbness. I could feel the instrument working on my eyeball. Not really painful but I could feel like a stick was being manipulated in my eyeball. The feeling was somehow sensational and frightful. I was so tensed during the entire procedures and the doctor told me several times to relax.

The surgery is called Phacoemulsification Cataract Surgery. It is a combination of microincision procedure, phacoemulsification (ultrasonic cataract removal), and a foldable lens implant. This type of procedure is considered state-of-the-art for cataract surgery today.


The most commonly used cataract incision is about 3 millimeters in size – just about one-eighth of an inch! Because of the careful construction of this incision, and its small size, the incision is generally self-sealing. This translates to a “no-stitch” type operation.


The surgeon then creates an opening in the capsule, which is a micro-thin membrane surrounding the cataract. This procedure, called capsulorhexus, requires extraordinary precision since the capsule is only about four-thousandths of a millimeter thick! This membrane is actually thinner than a red blood cell and the surgeon must delicately remove the capsule while manipulating instruments within the anterior chamber – a space only 3 millimeters deep!


Phacoemulsification is the aspect of the procedure in which ultrasonic vibrations are used to break the cataract into smaller fragments. These fragments are then aspirated from the eye using the same instrumentation.


The surgeon may elect to create grooves in the cataract, and subsequently break the cataract into smaller pieces using the phacoemulsification tip and a second instrument passed through a smaller “side-port” incision.


The lateral view of the procedure shows the phacoemulsification tip being placed into the substance of the cataract by the eye surgeon. The “phaco” aspect of the procedure is used to remove the denser central nucleus of the cataract.


Once the denser central nucleus of the cataract has been removed, the softer peripheral cortex of the cataract is removed using an irrigation/aspiration handpiece. The posterior, or back side, of the lens capsule is left intact to help support the intraocular lens (IOL) implant.


The intraocular lens is often folded and passed through the tiny incision where it is opened (implanted) inside the “capsular bag”. In this illustration, the lens is being inserted via an “injector”. This is an instrument designed to help keep the incision size small while allowing implantation of a 6 millimeter lens through a 3 millimeter (or even smaller) incision!


The IOL is shown here implanted within the “capsular bag” where it is neatly centered. The springy “arms” of the IOL, known as haptics, hold the lens implant within the capsular bag. The IOL does not generally require sutures to remain in good position.


This lateral view of the IOL implant shows the lens within the “capsular bag,” which is the desired location. This position is the same as that of the natural lens (cataract) of the eye and, therefore, is generally tolerated best and provides the most optimal visual results. At this stage, the cataract operation with IOL implantation is complete.

The article was extracted from EyeMDLink.

The procedure took not more than 40 minutes and I was done. I was taken to the resting area in front of the surgery room for a rest and a cup of hot drink. Here’s the photo taken myself at the rest area.

After the 10 minutes of rest, I was escorted down the stairs. I took my medication and headed back to the hotel.

I had to go back to the clinic for examination remove the tiny stitches. Here’re some photos of my eyes taken at the clinic after the bandage was removed.

Tags: ,

Comments

4 Responses to “Phacoemulsification Cataract Surgery”

  • 潜龙在天 on July 8th, 2007 2:47 1

    Hi,

    I did not know about cataract surgery until I read your blog. Very informative.

    Take care.

  • Video of phacoemulsification cataract surgery on March 25th, 2008 1:06 2

    [...] June I had phaco to remove cataract on my right eye due to retina repair. Read more here. While surfing for some information, I found this video showing how this modern cataract surgery [...]

  • Laser Surgery on March 25th, 2008 10:53 3

    [...] had my cataract surgery on June 19, 2007. Read here. I also posted a video of a cataract surgery here. The surgery removed my natural lens which had [...]

  • Lusel on May 14th, 2008 0:22 4

    Thank you for the informations..

Leave a Reply