Archive January 2018 XIX, No. 1

What's New in Cataract Extraction Technology

New devices and tweaks to current ones aim to make cataract surgery so easy even a reporter can do it.

Joe Madsen

Joe Madsen, Associate Editor

BIO

Cataract
EASY The latest platforms are making cataract extraction so simple and easy to control that even Outpatient Surgery's Joe Madsen could perform the operation with a little guidance.

Cataract surgery may be the world's most successful and efficient outpatient surgery. The rate of serious complications is minuscule, and many surgeons can do the procedure in under 10 minutes. Yet the quest to produce technology that improves outcomes and shortens case times even more continues on, as you'll see in "The Latest in Cataract Extraction" on page 62.

Safe cataract surgery depends on keeping fluidic volume inside the anterior chamber — the tiny space where cataract surgery takes place — stable throughout the procedure. Phaco machines do this by infusing irrigating solution at the same time the surgeon is aspirating lens material. However, if fluid replacement lags behind aspiration too much, the chamber will collapse and the capsular bag will push forward.

"When you emulsify larger pieces of nucleus, it can obstruct the lumen," says Mitch Schultz, MD, a Pasadena, Calif., ophthalmologist.

When the probe suddenly sucks that nucleus in and occlusion breaks off, intraocular pressure can quickly drop and the posterior capsule can move forward. If the bag contacts the tip of the phaco probe as the surgeon is delivering ultrasound energy and aspirating, the capsule can rupture. Capsular rupture increases the risk for intraocular infection, swelling of the retinal tissue and retinal detachment.

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