What Is Phaco Cataract Surgery?

Phacoemulsification, popularly known as “Phaco”, is a modern surgical technique used to restore vision in people with cataracts (clouding of the eye’s natural lens). Phacoemulsification surgery replaces the faulty lens with a new intraocular lens (IOL). Cataracts mainly develop due to aging; however, other causes include trauma to the eye, excessive exposure to UV rays, long-term use of medications like anti-seizure medications, steroids, etc., congenital defects, and family history of cataracts. Blurred vision, visual impairment, double vision in the affected eye, faded colors, and a halo surrounding the lights are common symptoms you may experience if you have cataracts. 

Read on to learn more about what phaco is, how the procedure is performed, recovery after phaco surgery, and its advantages and disadvantages.

What is Phaco Cataract Surgery?

Phaco cataract surgery is painless and restores your vision affected by cataracts. This surgery uses ultrasonic waves to break the lens into tiny fragments. This is known as the liquefaction of the lens. These fragments are suctioned out of the eye with a vacuum. The damaged or clouded lens is replaced with an artificial lens (IOL). The aspirated fluids are replaced with a balanced salt solution irrigation to maintain the anterior chamber’s fluidity.

Currently, phaco surgery is far better and more modern than traditional surgeries because of its safety, efficacy, and faster postoperative recovery. It was first introduced by Kelman in the year 1967 and has revolutionized cataract management. Phaco is also known as small incision cataract surgery. 

Phacoemulsification Mechanism

During this procedure, the surgeon exposes the lens of your eye within its surrounding capsule. A hand-held device is used to emit high-frequency sound waves, which break up the lens into an emulsified gel-like mass. This mass is flushed out, irrigated with sterile fluids, and suctioned out of the eye with a vacuum (aspiration).

The hand-held ultrasound device used is referred to as a phaco machine. It comprises a handpiece, a foot pedal , and an irrigation and aspiration system. It also consists of a variety of tips bent at different angles to accurately deliver the ultrasonic energy.

How is Phaco Cataract Surgery Performed?

Phacoemulsification is performed as an outpatient procedure and takes about 10 to 20  minutes.to complete.

• Pre-procedure (Before the surgery)
  • Your eye surgeon will record your detailed medical history to check for debilitating diseases like diabetes (increased blood sugar levels), hypertension (increased blood pressure), and any blood disorders, as these, if not under control, may pose a risk of complications post-surgery.
  • You will be asked to stop blood thinners and antihistaminics a few days before the procedure, as they can increase the risk of bleeding during and after surgery. 
  • Your surgeon will examine the eyes with an ultrasound. This painless procedure helps you check the shape and size of your eye to determine what type of IOL suits you best.
  • Your surgeon may prescribe prophylactic eye drops 1 week before the surgery. This is done to prevent infections or inflammation during and after the surgery. 
  • You will be asked to fast for at least 8 to 12 hours before the procedure.
  • You will be advised to avoid drinking alcohol at least 24 hours before the surgery.
  • Anesthesia is given according to your age and the severity of your cataract:
    • Topical anesthesia, applied directly to the eye .
    • Anesthetic eye blocks injected into the eye.
    • Facial nerve block to prevent eyelid movement.
    • General anesthesia for children and people with traumatic eye injuries, or those with distress .

• Procedure (During the surgery)
  • Once the anesthesia is delivered, and the eye is numbed, you will be asked to lie down in a supine position on the operating table.
  • Your eye will be held open with a device called a speculum.
  • Your surgeon makes 1 or 2 small incisions (2 to 4 mm) at the edge of the cornea (the transparent layer that forms the front of your eye).
  • A small opening will be created in the membrane surrounding the lens. Your surgeon will inject saline into the capsule (the natural sac holding the lens in place). This will facilitate the separation of the lens from the capsule.
  • Your surgeon will use a titanium needle (also known as a phaco probe) to insert into the cornea. This probe will be directed into the central part of the cataract (the densest  part).
  • This divide will pulsate (oscillate) at a fast speed and break up the cataract into minute pieces. The foot pedal works to control the rate of oscillation. 
  • The fragmented minute pieces are then suctioned out by a small hole present at the tip of the ultrasonic probe.
  • Once the central part of the cataract is emulsified and fragmented, the surgeon moves to clear the peripheral part of the closed lens.
  • As the whole lens is fragmented, known as “chopping”, the irrigation and aspiration system is simultaneously activated to suction out the debris. The irrigation system basically maintains intraocular pressure, carries lens particles out of your eye in the aspiration system, and cools down the phaco handpiece. 
  • The intraocular lens implant (IOL) is inserted into the capsule to replace the clouded lens. These foldable lenses are usually made up of silicone or acrylic and are responsible for shortening the recovery period.
  • Generally, very small or no stitches are used to close the incision, as the corneal incisions are self-sealing given their wound architecture.

Phacoemulsification surgery can also be done by using laser technology. The procedure remains the same, the only difference being  that a laser is used instead of a knife . The main advantage is the accuracy and precision of the incision and a quicker recovery time.

• Post-procedure (After the surgery)
  • You will be kept under observation in the recovery room for 30 minutes post-surgery until the effects of anesthesia wear off.
  • A family member or friend should drive you home since you cannot drive post-surgery due to blurred vision.
  • You need to follow your surgeon’s instructions for faster healing and recovery, and rest as much as possible.
  • You will have blurred vision for the initial 24 to 48 hours, so avoid activities like watching TV, using a computer, and reading for the time being. Further side effects such as popped blood vessels and bruising may be there for a few days. 
  • Use the eye drops prescribed by your surgeon to prevent infection and other post-op complications. This includes antibiotics, steroids, lubricating, and anti-inflammatory eye drops.
  • Use a protective eye shield at  night while sleeping to prevent injury and accidental rubbing of the operated eye.
  • Use protective sunglasses outdoors, do not lift anything heavy, do not drive, and also don’t bend down.
  • Avoid getting exposed to dust and dirt.
  • Avoid head baths, washing your face, driving, and cooking for 2 to 4 weeks post-surgery.
  • Avoid swimming, sauna, and hot tubs for at least 4 weeks.
  • Avoid eye makeup for at least 4 weeks post-surgery.

Complete recovery after phaco cataract surgery may take around 2 to 4 weeks.

What Are The Advantages Of Phaco Surgery?

Phacoemulsification is a popular cataract surgery and is preferred over traditional methods owing to the following advantages:

• It is an outpatient procedure, and hence does not require hospitalization.
• The incisions are small, with fewer postoperative complications (such as macular edema and vitreous loss).
• Since the incisions are small, few or no stitches are required.
• There is less chance of astigmatism.
• Minimal bandages are required for the dressing.
• Recovery is fast with good visual outcomes.
• Can resume your daily routine activities in a short time post-surgery.
• It’s speedy and quicker than ECCE (another popular type of cataract surgery).
• The entire lens capsule is retained, giving a high lens stability.
• Finding a surgeon, who performs phaco, is easier. 
• Final spectacles that might be required post-surgery can be prepared at 1-2 weeks. 
• One can go for multifocal, toric as well as EdOF lenses with phaco.
• Injections and blocks are not required. 

Disadvantages of Phacoemulsification

Phaco also has some drawbacks:

• It may not be suitable for all cataract patients and some might find ECCE or FLACS to be a better option. While ECCE is cheaper, FLACS is better for advanced and complicated cataracts. 
• Costly instruments are needed for this highly mechanized surgery, making it expensive.
• Highly skilled and trained professionals are required. 
• Patients with hard cataracts or weak/loose zonules may not be suitable candidates for phaco surgery. 
• Phacoemulsification can cause a rare complication called a dropped lens, dropped lens nucleus or dropped nucleus. This happens when the broken fragments of the lens fall into your eye’s vitreous humor (the gel-like liquid filling the back of the eye). This may further require treatment. 

Note that the outcomes of phacoemulsification cataract surgery are dependent upon factors like eye condition, surgeon, lenses chosen, and the hospital chosen. The eye should be free of any other corneal and retinal disorders. And the choice of the lens also differs since the visual needs of every individual are different. 

Takeaway

Phacoemulsification is a modern, revolutionary cataract surgery that aims to correct your vision by removing the damaged and clouded lens and replacing it with a new intraocular lens. 4-5 weeks are needed to achieve optimal vision and complete healing post-phaco. 

For further queries, consult our team of experienced and well-trained eye surgeons at Medfin. We’ll be  happy to help you throughout your cataract surgery with faster recovery as one of our major objectives.

Also Check: Eye Surgeons For Phacoemulsification in Bangalore.

                      Cost of Phacoemulsification in Bangalore

 

 

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The content on this site is the copyright of Medfin and is intended for informational and educational purposes only. This should not be considered as a substitute for medical and surgical expertise. Results from any treatments or surgeries are subjective to an individual patient and the type of procedure/ surgery performed. Please seek professional help regarding any medical concerns. Medfin will not be responsible for any act or omission arising from the interpretation of the content present on this page.