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Extracapsular Cataract Extraction

A Less Common Method Of Cataract Surgery Is Extracapsular Cataract Extraction (ECCE). This Procedure, Which Was Developed Before Phaco, Is Often Used For Removal Of Very Advanced Cataracts That May Be Too Hard To Break Up Using Phaco Or In Patients Who Have Multiple Eye Conditions That Render Phaco A Less Desirable Surgical Option.

ECCE Requires A Larger Incision Than Phaco, Perhaps 10 To 12 Millimeters Long, At The Side Of The Cornea So The Cataract Can Be Removed In A Single Piece. Visual Recovery May Be Slower After ECCE Than Phaco And There May Be More Discomfort Because Of The Larger Incision And Sutures That Are Required To Close It.

Once The Cataract Is Removed, An IOL Is Implanted In The Eye. Given That A Larger Incision Has Been Made To Remove The Cataract-Damaged Natural Lens, The Surgeon Has The Option Of Inserting A Nonfoldable IOL Made From A Medical-Grade Plexiglas-Like Material Or A Foldable Material As Discussed Above.


The Diagnosis Of Cataract Is Usually Made When The Patient Begins To Notice Changes In His Or Her Vision And Consults An Eye Specialist. In Contrast To Certain Types Of Glaucoma, There Is No Pain Associated With The Development Of Cataracts. The Specific Changes In The Patient's Vision Depend On The Type And Location Of The Cataract. Nuclear Cataracts Typically Produce Symptoms Known As Myopic Shift (In Nearsighted Patients) And Second Sight (In Farsighted Patients). What These Terms Mean Is That The Nearsighted Person Becomes More Nearsighted While The Farsighted Person's Near Vision Improves To The Point That There Is Less Need For Reading Glasses. Cortical And Posterior Subcapsular Cataracts Typically Reduce Visual Acuity; In Addition, The Patient May Also Complain Of Increased Glare In Bright Daylight Or Glare From The Headlights Of Oncoming Cars At Night.

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The Risks Of Extracapsular Cataract Extraction Include : -
  • Edema (Swelling) Of The Cornea.
  • A Rise In Intraocular Pressure (IOP).
  • Uveitis. Uveitis Refers To Inflammation Of The Layer Of Eye Tissue That Includes The Iris.
  • Infection. Infection Of The External Eye May Develop Into Endophthalmitis, Or Infection Of The Interior Of The Eye.
  • Hyphema. Hyphema Refers To The Presence Of Blood Inside The Anterior Chamber Of The Eye And Is Most Common Within The First Two To Three Days After Cataract Surgery.
  • Leaking Or Rupture Of The Incision.
  • Retinal Detachment Or Tear.
  • Malpositioning Of The IOL. This Complication Can Be Corrected By Surgery.
  • Cystoid Macular Edema (CME). The Macula Is A Small Yellowish Depression On The Retina That May Be Affected After Cataract Surgery By Fluid Collecting Within The Tissue Layers. The Patient Typically Experiences Blurring Or Distortion Of Central Vision. CME Rarely Causes Loss Of Sight But May Take Between Two And 15 Months To Resolve Completely.


ECCE Is Almost Always Elective Surgery—Emergency Removal Of A Cataract Is Performed Only When The Cataract Is Causing Glaucoma Or The Eye Is Severely Injured Or Infected. After The Surgery Has Been Scheduled, The Patient Will Need To Have Special Testing Known As Keratometry If An IOL Is To Be Implanted. The Testing, Which Is Painless, Is Done To Determine The Strength Of The IOL Needed. The Ophthalmologist Measures The Length Of The Patient's Eyeball With Ultrasound And The Curvature Of The Cornea With A Device Called A Keratometer. The Measurements Obtained By The Keratometer Are Entered Into A Computer That Calculates The Correct Power For The IOL.

The IOL Is A Substitute For The Lens In The Patient's Eye, Not For Corrective Lenses. If The Patient Was Wearing Eyeglasses Or Contact Lenses Before The Cataract Developed, He Or She Will Continue To Need Them After The IOL Is Implanted. The Lens Prescription Should Be Checked After Surgery, However, As It Is Likely To Need Adjustment.

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Medical Treatment

As Of 2003 There Are No Medications That Can Prevent Or Cure Cataracts. Many Ophthalmologists, However, Recommend A Well-Balanced Diet As Beneficial To The Eyes As Well As The Rest Of The Body, On The Grounds That Some Studies Suggest That Poor Nutritional Status Is A Risk Factor For Cataract. While Vitamin Supplements Do Not Prevent Cataracts, There Is Some Evidence That An Adequate Intake Of Vitamins A, C, And E Helps To Slow The Rate Of Cataract Progression. Elderly People Who May Be At Risk Of Inadequate Vitamin Intake Due To Loss Of Appetite And Other Reasons May Benefit From Supplemental Doses Of These Vitamins.


Patients Can Use Their Eyes After ECCE, Although They Should Have A Friend Or Relative Drive Them Home After The Procedure. The Ophthalmologist Will Place Some Medications—Usually Steroids And Antibiotics—In The Operated Eye Before The Patient Leaves The Office. Patients Can Go To Work The Next Day, Although The Operated Eye Will Take Between Three Weeks And Three Months To Heal Completely. At The End Of This Period, They Should Have Their Regular Eyeglasses Checked To See If Their Lens Prescription Should Be Changed. Patients Can Carry Out Their Normal Activities Within One To Two Days Of Surgery, With The Exception Of Heavy Lifting Or Extreme Bending.

Most Ophthalmologists Recommend That Patients Wear Their Eyeglasses During The Day And Tape An Eye Shield Over The Operated Eye At Night. They Should Wear Sunglasses On Bright Days And Avoid Rubbing Or Bumping The Operated Eye. In Addition, The Ophthalmologist Will Prescribe Eye Drops For One To Two Weeks To Prevent Infection, Manage Pain, And Reduce Swelling. It Is Important For Patients To Use These Eye Drops Exactly As Directed.

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