Name of the Procedure:

Extracapsular Cataract Removal with Insertion of Intraocular Lens Prosthesis (1-Stage Procedure); also known as complex cataract surgery utilizing manual or mechanical techniques such as irrigation and aspiration or phacoemulsification.

Summary

Extracapsular cataract removal with intraocular lens (IOL) insertion is a surgical procedure to remove a clouded lens from the eye and replace it with an artificial intraocular lens. This complex version of the procedure involves additional devices or techniques that are not generally used in routine cataract surgeries.

Purpose

This procedure addresses clouding of the natural lens of the eye, known as cataracts. The goal is to restore clear vision by removing the cloudy lens and replacing it with a clear artificial lens.

Indications

• Blurred or dim vision due to significant cataracts
• Difficulty performing everyday activities such as reading or driving
• Conditions where cataract removal is complicated by other ocular or systemic factors

Patient criteria:

• Patients whose cataracts interfere with quality of life and cannot be managed with non-surgical treatments
• Patients who require advanced techniques due to complications or complexities in their eye condition

Preparation

• Fasting may be required for several hours before surgery.
• Adjustment or discontinuation of certain medications, especially anticoagulants.
• Undergoing a comprehensive eye examination and specific tests like ocular ultrasound.

Procedure Description

1. Anesthesia: Local anesthesia with sedation to minimize discomfort and keep the patient relaxed.
2. Incision: A small incision is made on the side of the cornea.
3. Lens Removal:
   • Phacoemulsification: Using ultrasound waves to break up the cataract and suction the pieces out.
   • Irrigation and Aspiration: Using fluid to wash out the cataract.
4. IOL Insertion: An artificial intraocular lens is inserted to replace the natural lens.
5. Complexity: Use of specialized devices or techniques due to patient-specific complexities such as weak zonules or previous eye surgeries.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

The procedure is generally performed in an outpatient surgical center or hospital.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Common risks: Infection, bleeding, inflammation (swelling, redness).
• Rare risks: Retinal detachment, increased eye pressure, displacement of the artificial lens.
• Management: Prompt medical treatment and follow-up care.

Benefits

• Restoration of clearer vision.
• Improved ability to perform daily activities.
• Results are typically realized within a few days to weeks post-surgery.

Recovery

• Eye drops to prevent infection and reduce inflammation.
• Avoiding strenuous activities and eye strain.
• Wearing an eye shield at night for protection.
• Follow-up appointments for monitoring healing.

Alternatives

• Non-surgical: Eyeglasses or contact lenses.
• Surgical: Standard extracapsular cataract removal without complex techniques.
• Pros and Cons: Non-surgical options provide temporary relief; standard surgery may not be suitable for complex cases compared to the described procedure.

Patient Experience

• Minimal discomfort during the procedure due to local anesthesia.
• Possible mild pain, itching, or discomfort in the eye post-surgery.
• Pain management with prescribed medications and comfort measures like cold compresses.