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Management of Cataract…
Tips and Tricks
By
Dr. Amr Mounir
Assistant Professor of Ophthalmology
Sohag University
A cataract is a cloudy area
in the lens of the eye that
leads to a decrease in vision.
Symptoms may include
faded colors, blurry or
double vision, halos around
light,
trouble with bright lights, and
trouble seeing at night
Causes:
Age Trauma
Medications Systemic diseases
Complicated Cataract
Radiation Genetics
Inadequate vitamin C
Types: ( shape)
Nuclear sclerosis Cortical cataract
Posterior subcapsular cataract Anterior subcapsular cataract
Dense white mature Nuclear sclerosis and posterior
polar cataract
Preoperative preparation:
V/A:
Slit Lamp: Lid, anterior segment
Pupil:
B. Scan:
A.scan and biometry:
Systemic evaluation:
DN Blood pressure:
Tamsulosin (Flomax), a
common drug for
enlarged prostate
intraoperative floppy
iris syndrome
Types of surgery
Phacoemulsification
- The most common technique.
- It involves the use of a
machine with an ultrasonic
handpiece the lens material is
emulsified.
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 without
lens emulsification.
Extracapsular cataract extraction (ECCE)
Extracapsular cataract extraction
involves the removal of almost the
entire natural lens through
capsulotomy openings while the
elastic lens capsule (posterior capsule)
is left intact to allow implantation of
an intraocular lens.
Intracapsular cataract extraction (ICCE)
 Involves the removal of the lens and
the surrounding lens capsule in one
piece.
 The procedure has a relatively high rate
of complications due to the large
incision required and pressure placed
on the vitreous body.
 Indicated in extremely subluxated lens.
Complications of cataract surgery:
Complications of anesthesia
Retrobulbar hemorrhage
Perforation
Posterior capsular tear (Vitreous loss)
Endophthalmitis
Toxic anterior segment syndrome
(TASS)
Retinal detachment
Thank you

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