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Techniques of cataract removal

Extracapsular cataract extraction (ECCE): Extracapsular cataract extraction involves the removal of almost the entire natural lens while the elastic lens capsule (posterior capsule) is left intact to allow implantation of an intraocular lens. It involves manual expression of the lens through a large (usually 10â€"12 mm) incision made in the cornea or sclera. It is very rarely done now a days only indicated for patients with very hard cataracts or other situations in which phacoemulsification is considered to have potential problems.

Disadvantages

Manual small incision cataract surgery (MSICS)

This technique is an evolution of ECCE (see below) where the entire lens is expressed out of the eye through a self-sealing scleral tunnel wound (5-6 mm). An appropriately constructed scleral tunnel is watertight and does not require suturing. The "small" in the title refers to the wound being relatively smaller than an ECCE, although it is still markedly larger than a phaco wound. The advantage of this technique is low cost.

Disadvantages

Phacoemulsification "A keyhole incision only 2.2- 2.8 mm wide is made on the outside of the eye. A circular opening in the lens capsule exposes the cataract. Next the phaco-emulsifier is inserted. This sophisticated instrument uses high-speed ultrasound waves to break the cataract into tiny pieces which are suctioned out of the eye.

Advantages