Phacoemulsification Cataract Surgery:

Phacoemulsification is one of the most modern and efficient way of doing cataract surgery.

In phacoemulsification the lens matter of the eye is broken into tiny pieces(emulsification) with ultrasound energy and then these emulsified lens matter are aspirated out of the eye. After aspiration of all the lens matter an intra-ocular lens made of polymer is implanted into that place. This operation is performed through very small openings made into the eye.

Patient being prepared for phacoemulsification operation
Phacoemulsification operation
in progress
Irrigation aspiration is
in progress


The procedure involves the following steps-

A small opening (2 to 3 mm cut) is made on the peripheral cornea or at the corneo-scleral junction.
The human lens is covered by a thin transparent capsule (like a very thin plastic sheet). Front portion of this capsule is opened(cut) circularly.
An instrument much like the writing pen (called phaco handpiece)is inserted into the eye. The phaco handpiece is connected to the main phaco machine by two tubes.These tubes carry ultrasound energy and also fluid into and out of the eye (anterior chamber).
The phaco handpiece is activated by a foot switch and the cataractus lens is emulsified. All these time a special fluid continuously flow into and out of the eye through one of the tubes connected to the phaco handpiece.
At the same time the emulsified pieces of the lens matter are aspirated by vacuum action out of the eye.
This process goes on till the entire lens is taken out of the eye in pieces. At the end only the capsule of the lens remains in place.
The capsule is cleared completely of any remaining lens matter by a method called irrigation and aspiration.
The capsular bag is filled with a special fluid called visco-elastic (transparent thick liquid).
An intra ocular lens (different designs and materials are available ) is introduced within the capsular bag and placed correctly into position.
The visco elastic liquid is aspirated out of the eye and the surgery is completed by closing of the wound.
In this surgery generally no stitching of the wound is required


Intra-vitreal injection:

It is a way of delivering drugs directly into the eye for rapid, continuous and adequate availability.
Intra-vitreal injections are given into a space called vitreous cavity within the eye (refer to know your eyes section).Several types of intravitreal injections are available.

Lucentis(renibizumab),Avastin(bevacizumab),Eyelea(aflibercept),Ozurdex(sustained released steroids) are some of the drugs frequently used through intravitreal route.(photo)

Various diseases of the eye can be treated by intra-vitreal injections. The most important of them are Age-related macular degeneration(choroidal neovascular membrane), Diabetic macular edema, Proliferative diabetic retinopathy, Cystoid macular edema, Central retinal vein occlusion and branch vein occlusion, Eale's disease, choroidal neovascular membrane in myopia , and Central serous choroidopathy etc.



Medical retinal service - include diagnosis and treatment of Diabetic retinopathy, Age related macular degeneration, Retinal vascular diseases (CRVO,BRVO,Eale's Disease etc), degenerative (myopic maculopathy) and infectious retinal diseases .
Ocular oncology - deals with diagnosis and treatment of benign and malignant ocular tumours like retinoblastoma, malignant melanoma, optic nerve tumour (glioma), choroidal haemangioma ,choroidal osteoma etc.
Neuro ophthalmology - diagnosis and management of diseases involving the optic nerve and other nerves of the eye. i.e. optic neuritis, papilloedema, ophthalmoplegia,neurological ptosis, ticks(frequent blinking of the eye) etc.
Glaucoma clinic - diagnosis and treatment of various types of glaucoma (primary open angle glaucoma, angle closure glaucoma, secondary glaucoma) are done.
Cataract clinic - diagnosis and treatment(surgeries) of all types of cataract are done. i.e. Phacoemulsification, extra capsular cataract surgery, small incision cataract surgery, pediatric cataract surgery etc.
Uvea Clinic - diseases involving the uveal tract(a highly vascular layer inside the eye consisting of choroid, ciliary body and iris) are termed as uveal disease. Uveal disease generally run a very chronic course. Modern sophisticated instruments (Fundus fluorescein angiography,Optical coherence tomography,Ultrasound biomicroscopy etc) are used to assist diagnosis and treatment.





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