Phacoemulsification or ‘phaco’ is the surgical procedure for the treatment of cataract. It is the newest surgical technique performed by most Eye Specialist in Lahore. This incision-less procedure is considered safe and cost-effective for the patients. Read on to know more about cataract, phacoemulsification, its procedure and benefits:

What is cataract?

Cataract refers to the clouding of the natural lens of the eye, which impacts vision and makes activities of daily living difficult. Aging is the most common cause of cataract formation, though recently, other causes like medication use and certain medical conditions, are on the rise. The latter includes diabetes, hypertension and history of trauma; the former, on the other hand, includes the long-term use of steroids.

There are several types of cataract, including nuclear, cortical and subcapsular; some babies are born with congenital cataracts due to infections like congenital rubella. All types of cataracts affect vision, with frequent change in eyeglasses, difficulty seeing especially at night, seeing halos around lights, fading of colors and glares.

Cataracts are treated with surgical removal of the cataract with replacement of artificial intraocular lens (IOL). Cataract surgery is of three types:

Phacoemulsification
Femtosecond laser-assisted cataract surgery (FLACS)
Extra-capsular cataract extraction (ECCE)

Of these, phacoemulsification is the most commonly performed surgery throughout the world for common cataracts.

What is phacoemulsification?

Phacoemulsification is the liquefaction of the natural lens of the eye using ultrasound technology. This ultrasound is delivered through a special probe after making a small section in the cornea and entering the lens. Following the breakdown of cloudy cataract material, the debris is removed through gentle suction from the eyes. Compared to conventional cataract removal surgery, phacoemulsification has a better healing time, quicker recovery period and offers better patient safety.

What is the procedure of phacoemulsification?

The procedure of phacoemulsification includes:

Phacoemulsification can be done under local anesthesia or topical anesthesia, depending on the preference of the surgeon.
Two small sections are made on the cornea after pupil is dilated and numbing medication is administered. A dilated pupil offers better access to the cataract, and more ease to the surgeon.
Through a bent needle, the surgeon then enters the anterior chamber or the region just behind the cornea. With this needle, an opening is made in the lens capsule.
Once the lens is exposed, a phaco probe i.e. a thin pen-like instrument is inserted in the eye.
This phaco probe is used to break down the cataract into small pieces using ultrasound waves.
The debris is then removed through suction process. Simultaneous irrigation and aspiration are done to maintain the intraocular pressure.
In phacoemulsification, the posterior portion of the lens capsule is left intact to provide support for the intraocular lens.
Depending on the refractive error of the patient, and the axial length of the eye, a suitable IOL is inserted in the eye. These IOLs restore vision almost immediately after the surgery.
Following the implantation of the intraocular lens, the wound is closed by hydrating the cornea. Because of the nature of the section made on the cornea, no sutures or stitches are needed to close the wound. In fact, this type of section is self-healing.
During the surgery, the patient is awake and breathing normally. Only in a small percentage of patient, sedation may become necessary.

What are the benefits of phacoemulsification?

Compared to conventional cataract surgery like ECCE, phacoemulsification offers the following benefits:

Phacoemulsification is a suture-less surgery, unlike ECCE, in which stitches are used to close the incision and these sutures have to be removed at a later date.
The opening of the anterior capsule in phacoemulsification results in better stability of the IOL, which is not the case in ECCE, in which an irregular opening is made.
The incidence of corneal astigmatism is lesser with phacoemulsification, as the section or incision is smaller. This means that only a few people need glasses for far vision after phacoemulsification. This is not the case in ECCE, in which dependency on glasses is more common.

Phacoemulsification has lesser incidence of dangerous complications like vitreous loss, wound leakage, retinal detachment and endophthalmitis. More information about these sight-threatening complications is available at oladoc.com.