One-Stitch,
No-Stitch
Small Incision Cataract Surgery
In order to remove a cataract, and
place an implant, an incision must be made in the upper part of the eye, under the lid.
The size may vary (see illustrations) from 3 to 10 millimeters (1 inch = 25 millimeters),
depending on the technique used and the size of the intraocular lens implant.
The smaller would size requires removal of the cataract
with phacoemulsification (see illustration). This rapidly vibrating suction tip emulsifies
the hard cataract and suctions it out through a 3 mm (1/8 inch) incision. We began the
regular use of phacoemulsification in Knoxville in 1973 because of the advantage of more
rapid rehabilitation and less astigmatism (in an astigmatic eye, the corneal window is
somewhat football shaped, rather than basketball shaped or spherical).
If the wound is enlarged slightly, to 5 or 6 mm, a
standard, plastic intraocular lens implant can be placed. Newer foldable lenses can be
placed in the eye without enlarging the wound at all.
This would opening can be closed with one suture or in
some cases no sutures are needed for closure.
We feel that the safest and best cataract surgical
procedure should be designed for each individual patient’s eye, in his or her best
interest. We have been performing small-incision cataract removal (phacoemulsification)
for over 17 years, and now it is combined with small incision intraocular lens implants,
when it is the best for that individual.
We are continuing to provide the latest in safe, proven
techniques in cataract removal and lens implantation for our patients. We will discuss
your case with you and perform the safest and best procedure for your particular and
individual needs.
The "YAG" Laser
In modern cataract surgery, the lens capsule is
left in the eye to hold the implant lens. In some cases, this capsule gets cloudy months
to years after cataract surgery. This cloudiness may cause one to think that the cataract
is returning.
The solution is to make a small opening in the capsule
behind the lens implant with a YAG laser. This type of laser concentrates the light energy
so that a tine tissue disruptive explosion occurs that opens a small window in the
capsule, which clears the vision. The capsule doesn’t cloud again. (This can be done
as an office procedure.) We must watch for possible glaucoma or retinal complications
(increased floaters of flashes) post-operatively. Cataracts are not removed with the YAG
laser.
