intracapsular cataract extraction

The term "intracapsular cataract extraction" refers to a surgical procedure in which a turbid cataract component is removed together with a transparent (mostly the case) capsule. It comes at the expense of the sacrificial capsule and the intraocular stability associated with the capsule. Intracapsular cataract extraction requires a large surgical incision, special surgical instruments, and a large disturbance to the vitreous. It takes a long time to stay in bed after surgery, which often makes it difficult for patients to accept. Since the entire lens is removed, postoperative complications such as corneal decompensation, pupillary up-regulation, retinal detachment, and macular cystic edema often occur. In particular, an aphakic state of the eye that is difficult to correct is often difficult for patients to accept. Due to the above shortcomings, it has rarely been applied in clinical practice. Treatment of diseases: age-related cataract traumatic cataract cataract Indication 1. Senile cataract. 2. Lens dislocation or subluxation, lens deformity. 3. Some traumatic cataracts incorporate foreign bodies in the lens. 4. Cataract associated with lens cortical allergy. Contraindications 1. High myopia combined with cataract; 2. Congenital or developmental cataracts; 3. The contralateral ocular cataract extraction was performed in the contralateral eye; 4. Retinal detachment occurs after surgery; 5, a wide range of iris adhesions combined with cataract; 6, combined with ocular trauma and vitreous lesions. Preoperative preparation 1. Comprehensive evaluation of systemic diseases and lesions. 2. Start 3 days before surgery, eye with antibiotic eye drops, clear on the day of surgery, rinse the conjunctival sac and lacrimal duct with 0.25% chloramphenicol or gentamicin solution. Surgical procedure 1. Opening: Open with a wire opener. Or open with a suture. The suture sputum should be infiltrated under the upper and lower suede, and the upper sputum should be made 1 or 2, and the lower jaw should be a sputum suture, 3 mm from the gingival margin. 2. Upper rectus fixed suture: The upper rectus muscle tendon is clamped 8 mm behind the corneal margin at the 12 o'clock clock position with a straight spur, and the 1-0 silk thread is passed through the upper rectus adhesion point behind the suture. Upper rectus muscle. 3. Make a conjunctival flap: a conjunctival flap with a corneoscleral margin as the base, 5 to 6 mm wide, and the inverted conjunctival flap is peeled off to the limbus. It can also be used as a conjunctival flap based on the iliac crest, that is, the conjunctiva is cut along the limbus by ophthalmic scissors. 4. Angle scleral incision and pre-sewn suture: fully expose the limbus and stop bleeding. After the gray line of the limbus is cut off, the vertical plate is cut open, and the depth is 2/3 full layer. The incision is required to be neatly standardized. The slit range can be from 9:30 to 2:30 clock position. Two preset stitches are made at the 11:00 and 1:00 clock positions, respectively. Use a 4-0 black line or a 6-0 Vicryl absorbable suture for 1/2 full thickness stitching and then pull the sleeve out of the slit groove. 5. Cut the angle of the limbus: After the preset stitches are arranged, they are placed on both sides. The slit is penetrated by the sharp blade at an oblique angle parallel to the iris surface. The corneoscleral scissors are then used to enlarge the incision to the predetermined position on both sides. Be careful to protect the preset stitches from being cut. 6. Make an iris root resection above the nose or above the ankle. For the adhesion after the pupil, the micro-iris restorer can be inserted into the iris from the iris perforation to separate the adhesion. 7. After finishing the preset suture, the assistant gently pry open the corneal flap with the gums and use the absorbent sponge to absorb the surface moisture of the lens. And hold the water injector with bss in order to release the water in time when the frozen water misapplied the iris tissue. The operator left the iris recovery device to push the iris toward the posterior lip of the incision to reveal the upper part of the lens and the equator. The right hand holding the freezing head is placed on the upper 1/3 surface of the lens. After a few seconds of cooling, a frozen white circle of about 3 mm diameter appeared around the freezing head, indicating that the bond was firm. Gently swing the cryostat and tear the upper and lower suspensory ligaments in an alternate lifting motion, slowly pulling the lens forward and upward until it is removed over the incision. 8. Close the incision and immediately close the incision as the lens is removed and tighten the preset suture ligation. The tensioned preset suture is always toward the scleral side, such as pulling in the opposite direction, which will open the incision. The incision was interrupted or continuously sutured with a 5-0 silk thread or a 10-0 nylon thread to restore the iris and restore the pupil to a circular shape. Reconstruct and suture the conjunctiva. complication eye pain.

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