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A cataract is a cloudy area in the lens of the eye that leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry or double vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing faces. Poor vision caused by cataracts may also result in an increased risk of falling and depression. Cataracts cause half of all cases of blindness and 33% of visual impairment worldwide.
Eye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist. The eye is a very fragile organ, and requires extreme care before, during, and after a surgical procedure to minimise or prevent further damage. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions. Mentions of eye surgery can be found in several ancient texts dating back as early as 1800 BC, with cataract treatment starting in the fifth century BC. Today it continues to be a widely practiced type of surgery, with various techniques having been developed for treating eye problems.
Radial keratotomy (RK) is a refractive surgical procedure to correct myopia (nearsightedness). It was developed in 1974 by Svyatoslav Fyodorov, a Russian ophthalmologist. It has been largely supplanted by newer operations, such as photorefractive keratectomy, LASIK, Epi-LASIK and the phakic intraocular lens. Approximately 10% of all practicing ophthalmologists in the United States have performed several hundred thousand RK procedures.
Refractive eye surgery is optional eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. This can include various methods of surgical remodeling of the cornea (keratomileusis), lens implantation or lens replacement. The most common methods today use excimer lasers to reshape the curvature of the cornea. Refractive eye surgeries are used to treat common vision disorders such as myopia, hyperopia, presbyopia and astigmatism.
Phacoemulsification is a modern cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.
Intraocular lens (IOL) is a lens implanted in the eye as part of a treatment for cataracts or myopia. If the natural lens is left in the eye, the IOL is known as phakic, otherwise it is a pseudophakic, or false lens. Such a lens is typically implanted during cataract surgery, after the eye's cloudy natural lens has been removed. The pseudophakic IOL provides the same light-focusing function as the natural crystalline lens. The phakic type of IOL is placed over the existing natural lens and is used in refractive surgery to change the eye's optical power as a treatment for myopia (nearsightedness). This is an alternative to LASIK.
A phakic intraocular lens (PIOL) is a special kind of intraocular lens that is implanted surgically into the eye to correct myopia (nearsightedness). It is called "phakic" because the eye's natural lens is left untouched. Intraocular lenses that are implanted into eyes after the eye's natural lens has been removed during cataract surgery are known as pseudophakic.
Charles David Kelman was an American ophthalmologist, surgeon, inventor, jazz musician, entertainer, and Broadway producer. Known as the father of phacoemulsification, he developed many of the medical devices, instruments, implant lenses and techniques used in cataract surgery. In the early 1960s, he began the use of cryosurgery to remove cataracts and repair retinal detachments. Cryosurgery for cataracts remained in heavy use until 1978, when phacoemulsification, a procedure Kelman also developed in 1967, became the modern standard treatment. Kelman was given the National Medal of Technology by President George H. W. Bush and recognized as the Ophthalmologist of the Century by the International Congress of Cataract and Refractive Surgery in Montreal, Canada. He was also inducted into the National Inventors Hall of Fame in Akron, Ohio, and received the 2004 Lasker Award.
Cataract surgery, also called lens replacement surgery, is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract, and its replacement with an intraocular lens. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract, causing impairment or loss of vision. Some infants are born with congenital cataracts, and certain environmental factors may also lead to cataract formation. Early symptoms may include strong glare from lights and small light sources at night, and reduced acuity at low light levels.
Nuclear sclerosis is an age-related change in the density of the crystalline lens nucleus that occurs in all older animals. It is caused by compression of older lens fibers in the nucleus by new fiber formation. The denser construction of the nucleus causes it to scatter light. Although nuclear sclerosis may describe a type of early cataract in human medicine, in veterinary medicine the term is also known as lenticular sclerosis and describes a bluish-grey haziness at the nucleus that usually does not affect vision, except for unusually dense cases. Immature senile cataract has to be differentiated with nuclear sclerosis while making its diagnosis.
Iridodialysis, is a localized separation or tearing away of the iris from its attachment to the ciliary body.
Capsulorhexis or capsulorrhexis, also known as continuous curvilinear capsulorhexis (CCC), is a technique pioneered by Howard Gimbel used to remove the capsule of the lens from the eye during cataract surgery by shear and stretch forces. It generally refers to removal of a part of the anterior lens capsule, but in situations like a developmental cataract a part of the posterior capsule is also removed by a similar technique.
The von Graefe knife was a tool used to make corneal incisions in cataract surgery. Use of the knife demanded a high level of skill and mastery, and was eventually supplanted by modifications of cataract surgery through the Kelman phacoemulsification technique that emphasized a small incision.
Sanduk Ruit is an ophthalmologist from Nepal who has restored the sight of over 130,000 people across Africa and Asia using small-incision cataract surgery. He is also one of the founders of the Tilganga Institute of Ophthalmology.
Howard V. Gimbel FRCSC, AOE, FACS, CABES, is a Canadian ophthalmologist, university professor, senior editor, and amateur musician. He is better known for his invention, along with Thomas Neuhann, of the continuous curvilinear capsulorhexis (CCC), a technique employed in modern cataract surgery.
Eric John Arnott, MA, FRCS, FRCOphth was a British ophthalmologist and surgeon who specialized in cataracts, a condition which in many parts of the world still remains the principal cause of blindness. He is known for inventing new surgical techniques for treatment of various ophthalmological disorders, and received professional awards for his contributions.
Capsulotomy is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye. In modern cataract operations, the lens capsule is usually not removed. The most common forms of cataract surgery remove nearly all of the crystalline lens but do not remove the crystalline lens capsule. The crystalline lens capsule is retained and used to contain and position the intraocular lens implant (IOL).
Vitreous touch syndrome, is a late complication of intra capsular cataract extraction wherein the vitreous bulges through the pupillary aperture, and touches and attaches to the corneal endothelium.
Hydrodissection is the process of injecting small amounts of a special fluid into the capsule of the lens in the eye in order to make dissection easier. It makes the surgeon more capable of performing maneuvers during extracapsular or phacoemulsification surgeries.
Phacolytic glaucoma (PG) is a form of glaucoma which is caused due to a leaking mature or immature cataract. Inflammatory glaucoma which occurs in phacolysis is a condition which is a result of the leakage of protein within the lens into the capsule of a mature or hyper mature cataract and involves a simple procedure to be cured that is referred to as cataract extraction.
References
- ↑ Colvard, D. Michael (2009). Achieving Excellence in Cataract Surgery Chapter 4 - Hydrodissection and Hydrodelineation (PDF). pp. 27–31. Retrieved 2 June 2018.
- ↑ Singh, Kamaljeet (1 March 2010). Small Incision Cataract Surgery (Manual Phaco). JP Medical Ltd. ISBN 9788184489804 – via Google Books.