1. Phacoemulsification – The Gold Standard of Cataract Surgery
The incisional funnel with the Phaco incision.
Phacoemulsification (commonly known as Phaco) is considered as the Gold Standard for cataract surgery using the latest and most advanced surgical techniques and procedures. 96% of surgeons in USA and 90% in Western Europe perform cataract surgery by this method. The procedure is quick, simple and painless. It is carried out through a small (2.5-3mm), self-sealing incision. A high frequency ultra-sonic probe emulsifies or breaks the nucleus into small fragments and sucks the microscopic particles of the nucleus material out of the eye. A specially designed foldable intra-ocular lens (IOL) is then inserted, providing a permanent and safe replacement for the natural lens. This surgery is performed under local anesthesia.
Laser Eye Centre was the first centre in East and Central Africa to offer this type of surgery. Watch the video of how Phacoemulsification is done here:
2. Extra-Capsular Cataract Extraction (ECCE)
An opening is made on the front of the capsule and part of the anterior capsule; the nucleus and the cortex are then removed. A synthetic Intra-ocular lens is implanted in the empty capsular bag to replace the optical power of the removed lens.
ECCE is a good operating technique but, the size of the incision has to be larger than the nucleus, thus the incision is about 1cm or 10mm, which gives rise to the following limitations:
- Lengthy recovery period, as the incision is large and the healing period is longer. The patient will need 6 – 10 stitches, therefore stabilizing of vision takes between 6 weeks to 3 months.
- Astigmatism due to the large incision, distorts the cornea in most cases
- There is a risk of wound gap and infections.
- Patients are restricted from doing physical activities during the first month, like playing golf, driving, sexual intercourse etc. There is also increased postoperative pain due to the surgical trauma of the tissue.
3. Intra Capsular Cataract Extraction (ICCE)
This is the oldest method of cataract extraction. It is outdated and seldom performed. Here the whole lens is removed by using either forceps or a cryoprobe (freezing point). After this surgery, patients have had to wear very thick cataract glasses which are cumbersome, uncomfortable and can cause distortion.