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The natural lens has a capsular bag, that is, the lens capsule. According to the relationship between lens nucleus and capsular bag during surgical removal, it can be divided into intracapsular removal and extracapsular removal. After removing the turbid lens, it is often necessary to put an intraocular lens, which can be placed in the anterior chamber or posterior chamber, and in the posterior chamber, it can be placed inside or outside the capsule. Implantation of intraocular lens can not only restore vision, but also restore intraocular anatomical relationship and prevent anterior vitreous prolapse. If the anterior vitreous body comes out of the vitreous cavity and attaches to the cornea or iris tissue, it may pull the retina.

Intracapsular cataract extraction (ICCE): the corneoscleral margin was cut through a large incision, and the lens was frozen with a cryoprobe after entering, and the suspensory ligament was broken due to outward traction, and the lens was delivered.

Extracapsular cataract extraction (ECCE): Switch to capsulotomy to remove the lens.

Phacoemulsification: continuous annular capsulorhexis, phacoemulsification of lens nucleus, perfusion aspiration of lens cortex and intraocular lens implantation.

Phacoemulsification of cataract

Phacoemulsification of cataract is an important achievement of microsurgery. From 1967, Dr. KELMAN of the United States invented the first phacoemulsification instrument and used it in clinic. After more than 30 years of continuous improvement and perfection by many ophthalmologists, phacoemulsification has become an advanced and mature surgical method recognized by the world. Ultrasonic emulsification has been popularized in developed countries, and it has been introduced and popularized in China since 1992. During the operation, the phacoemulsification probe is inserted into a small incision in the cornea or sclera of the operating eye, and the turbid lens and cortex are squeezed into chylous shape, and then the chylous shape is sucked out by the suction perfusion system, while the anterior chamber is filled, and then the intraocular lens is implanted, so that the patient can see again. Phacoemulsification technology has truly realized the ideal of small incision, no pain, short operation time, no hospitalization and quick vision recovery.

What are the characteristics of phacoemulsification and intraocular lens implantation?

Compared with traditional surgery, phacoemulsification and intraocular lens implantation has the following advantages:

1. The surgical incision is small, compared with the traditional surgical incision 12MM, which is less than 3 mm.

2. The postoperative reaction is light, the incision heals quickly, and the vision recovery is faster and better.

3. Postoperative astigmatism is small, which is easier to correct or control.

4. The operation has better controllability, safety and stability.

5. The operation time is short, generally only about 15-30 minutes.

6. You don't need to be hospitalized, you can go home 1 hour.

7. Don't wait until the cataract matures before surgery.

Why should intraocular lens be installed after cataract extraction?

After cataract extraction, the lens, an indispensable structure, is lost in the eyeball, and the vision is still unclear. However, there are many shortcomings or deficiencies in wearing aphakic glasses (frame-type) and corneal contact lenses, so the most ideal method is to install intraocular lenses to restore the vision and visual field to normal. Under normal circumstances, after implantation of intraocular lens, it can be used for a lifetime.

Choice of len in cataract surgery

Monofocal intraocular lens: this is the most commonly used intraocular lens, which can improve myopia or hyperopia and is suitable for any crowd, but it has only a single focal length and can only provide the function of seeing far or near. If a monocular intraocular lens with telephoto function is implanted, patients can clearly see distant objects and wear reading glasses when doing close-range activities such as reading or playing cards. [ 1]

Adjustable intraocular lens: suitable for relatively young cataract patients. Depending on the contraction ability of ciliary muscle, the lens can clearly image objects at any distance in the retina with the eyeball, and can see things far and near clearly. Most people don't have to wear reading glasses after surgery. [ 1]

Trifocal intraocular lens: suitable for presbyopia cataract people who pursue high-quality life. It is a high-end functional intraocular lens with far, middle and near full vision, and the satisfaction degree of near and far vision is 100%. Good eyesight at night, you can read, drive and work at night, and you can have perfect overall eyesight without wearing glasses. Advantages: It has true midrange vision, reduces glare, and does not need to rely on pupils. Even in dim light, there is little glare and no chromatic aberration, and it can correct chromatic aberration by itself. [1] Preoperative examination of cataract surgery

Cataract patients have been weak for many years, and many diseases are complicated all over the body. In order to make the operation successful and prevent complications, some necessary local and general examinations should be carried out before operation.

1. General inspection

Eye examination before cataract surgery should include visual function (light perception, light direction and color perception). Routine slit lamp examination and intraocular pressure measurement. For suspected fundus lesions, electrophysiological examination, eye ultrasound examination, macular function examination, etc. Those who have undergone eye surgery can be counted as corneal endothelial cells if necessary.

According to the above preoperative examination, we can roughly evaluate the condition of the eyes to be operated, estimate the recovery of visual function after operation, and make preparations for possible complications and risk factors during operation.

There is no special regulation on the timing of cataract surgery. In the past, it was thought that cataract could be operated only after it was mature, but with the development of surgical technology, immature cataract can also be treated surgically. For patients with nuclear cataract who require high vision, if the vision is above 0.3, surgery can also be arranged.

2. Special patient examination

For patients with eye diseases at the same time, the timing, mode or sequence of operation should be carefully decided. For example, patients with chronic dacryocystitis should undergo dacryocystostomy or dacryocystectomy first, and patients with glaucoma can consider combined surgery of glaucoma and cataract.

For patients with cardiovascular disease, the condition should be controlled before operation; If conditions permit, electrical monitoring can be carried out in the operation center to ensure operational safety.

For diabetic patients, blood sugar should be controlled first and antibiotics should be used before operation to prevent infection. When acute or chronic inflammatory lesions appear all over the body or locally, they should be treated first.

Precautions before operation

1. If you have hypertension, diabetes or cough, please consult a doctor, and then perform cataract surgery after your condition is stable.

2. If you take medical drugs such as hypertension, diabetes or cough, please continue to take them before and after the operation and on the same day.

3. Do personal hygiene (shampoo and bath) the day before the operation.

Please clean your face on the day of operation, and don't use any cosmetics.

You can eat a little before the operation.

6. Be sure to be accompanied by your family on the day of the operation.