Phacoemulsification is a modern cataract surgery technique that uses ultrasonic energy to break up and remove the eye’s internal lens. Dr Supriya Sriganesh, executive director, Nethradhama Super Speciality Eye Hospital, Bengaluru, explains that the complication rate for phacoemulsification in modern day surgery is very low, in an interview with Rishita Khanna. Edited excerpts:
Explain the process of phacoemulsification in cataract surgery
Phacoemulsification technique employs ultrasound energy in the form of high frequency sound waves, to emulsify (break-up) the nucleus of the clouded lens (cataract) into a gelatinous mass. The mass is then suctioned out of the eye with a vacuum (aspiration). The procedure is completed by replacing the cataract with an IOL (intraocular lens).
What steps are involved in aspirating the emulsified lens from the eye?
The steps involved in aspirating the emulsified lens from the eye are using a phaco probe to chop the lens into multiple smaller pieces and using phaco energy to break up these pieces of the lens into micro fragments, which can then be sucked out of the eye using vacuum.
What are the potential complications from this procedure?
The complication rate for phacoemulsification in modern day surgery is very low. However, every surgical procedure carries a small margin of risk. Complications occur more often when the cataract has been left untreated for too long and has either become very dense or mature. Complications arise when the support around the cataract becomes weak and the lens cannot be placed in an ideal position. There are alternatives to manage such cases using special lenses. Other complications like post-operative infection happen rarely and only in cases where adequate care and precautions are not taken after the cataract surgery.
What pre-operative assessments are necessary to determine if phacoemulsification is suitable for a patient?
Usually, most cases of cataract are suitable for phacoemulsification. Only in certain cases, where the cataract is extremely dense or the structures around the lens are weak, phacoemulsification is not suitable. Pre-operatively, there are certain measurements taken to determine the power of the lens. The ophthalmologist examines the eye through a microscope, known as the slit lamp, grades the cataract and sees whether the structures around the lens are strong enough for surgery.
How long is the typical recovery period after the procedure?
Typically, the recovery time for patients is one week after undergoing phacoemulsification. The patient is recommended to refrain from touching or rubbing their eyes or allowing water to go directly into their eyes. Patients cannot have a head bath for about one week after a cataract surgery. Eye drops and dark glasses are provided for a few weeks after the surgery. However, the visual recovery requires just 2-3 days, after which patients can see everything very clearly.
What are the cost differences between phacoemulsification and other cataract removal methods?
Manual cataract surgery is the least expensive, but the risks and recovery time is higher. The costs are standard for phacoemulsification and the difference only depends on the type of lens selected to be implanted in the eye. There is a marginal difference between phacoemulsification and femto laser cataract surgery, where the latter is more expensive but comes with faster recovery time, improved safety, and visual outcomes.