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MVJ Medical College and Research Hospital Department of Ophthalmology

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14 views

MVJ Medical College and Research Hospital Department of Ophthalmology

Uploaded by

jnanesh
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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MVJ MEDICAL COLLEGE AND RESEARCH HOSPITAL

DEPARTMENT OF OPHTHALMOLOGY

SENILE MATURE CATARACT

MUST KNOW:

1. WHAT IS THE DEFINITION OF CATARACT?

2. WHAT IS MATURE CATARACT? WHAT IS THE COLOR OF THE LENS


IN MATURE CATARACT OPACIFICATION BECOMES COMPLETE THAT IS WHOLE OF
CORTEX IS INVOLVED.
COLOR OF THE LENS IS PEARLY WHITE

3. WHAT IS HYPERMATURE CATARACT? NAME THE 2 TYPES.


WHEN MATURE CATARACT IS LEFT IN SITU, THE STAGE OF HYPERMATURITY SETS IN.
2 TYPES:
a. MORGAGNIAN HYPERMATURE CATARACT
b. SCLEROTIC TYPE HYPERMATURE CATARACT.

4. WHAT IS LENS INDUCE GLAUCOMA AND NAME THE TYPES.


IN LENS INDUCED GLAUCOMA IOP IS RAISED SECONDARY TO SOME DISORDER OF
THE CRYSTALLINE LENS.
TYPES :
 PHACOMORPHIC GLAUCOMA
 PHACOLYTIC GLAUCOMA
 LENS PARTICLE GLAUCOMA
 LENS ASSOCIATED PHACOGENIC UVEITIS
 GLAUCOMA ASSOCIATED WITH PHACOANAPHYLAXIS.

5. WHAT IS PHACOMORPHIC GLAUCOMA? CLINICAL FEATURES OF PHACOMORPHIC


GLAUCOMA.
IT IS ACUTE SECONDARY ANGLE CLOSURE GLAUCOMA CAUSED BY INTUMESCENT
LENS OR ANTERIOR SUBLUXATION OF LENS OR DISLOCATION OF LENS OR
SPHEROPHAKIA.
CLINICAL FEATURES:
 FEATURES OF ACUTE CONGESTIVE GLAUCOMA
 PAIN
 NAUSEA VOMITING PROSTRATIONS
 RAPIDLY PROGRESSIVE IMPAIRMENT OF VISION
 PAST HISTORY OF INTERMITTENT ATTACKS OF SUBACUTE ANGLE CLOSURE
GLAUCOMA.

6. WHAT ARE THE OCULAR INVESTIGATIONS TO BE DONE BEFORE CATARACT SURGERY?


 SLIT LAMP EXAMINATION
 DILATED FUNDOSCOPY
 IOP MEASUREMENT : IF THERE IS RAISED IOP THERE ARE CHANCES OF
EXPULSIVE CHOROIDAL HAEMORRHAGE
 B SCAN
 KERATOMETRY,CORNEAL TOPOGRAPHY AND BIOMETRY
 LACRIMAL SAC SYRINGING : IF ANY MUCOUS SECRETION IS SEEN THERE ARE
HIGH CHANCES OF ENDOLPHTHALMITIS

7. TYPES OF CATARACT SURGERY.


a. INTRACAPSULAR CATARACT SURGERY
b. EXTRACAPSULAR CATARACT SURGERY
PHACOEMULSIFICATION
SICS
CONVENTIONAL ECCE

8. WHAT IS THE SITE AND SIZE OF THE INCISION IN CATARACT SURGERY?

9. ADVANTAGES OF ECCE OVER ICCE


 CAN BE PERFORMED IN ALL AGES WHEREAS ICCE CANNOT BE PERFORMED BELOW
40 YEARS OF AGE.

 POSTERIOR CHAMBER IOL CAN BE IMPLANTED AFTER ECCE, WHILE IT CANNOT BE


IMPLANTED AFTER ICCE.
 POSTOPERATIVE VITREOUS RELATED PROBLEMS (SUCH AS HERNIATION IN ANTERIOR
CHAMBER, PUPILLARY BLOCK AND VITREOUS TOUCH SYNDROME) ASSOCIATED WITH
ICCE ARE NOT SEEN AFTER ECCE
 INCIDENCE OF POSTOPERATIVE COMPLICATIONS SUCH AS ENDOPHTHALMITIS,
CYSTOID MACULAR OEDEMA AND RETINAL DETACHMENT ARE MUCH LESS AFTER
ECCE AS COMPARED TO THAT AFTER ICCE.
 POSTOPERATIVE ASTIGMATISM IS LESS, AS THE INCISION IS SMALLER.

10. DIFFERENCES BETWEEN SICS AND PHACOEMULSIFICATION

o CLEAR CORNEAL INCISION REQUIRED IS VERY SMALL IN


PHACOEMULSIFICATION
o CONTINUOUS CURVILINEAR CAPSULORRHEXIS (CCC) OF 4-6 MM IS
PREFERRED OVER OTHER METHODS OF ANTERIOR CAPSULOTOMY IN
PHACOEMULSIFICATION
o HYDRODISSECTION I.E., SEPARATION OF CAPSULE FROM THE CORTEX BY
INJECTING FLUID EXACTLY BETWEEN THE TWO IS MUST FOR
PHACOEMULSIFICATION
o NUCLEUS IS EMULSIFIED AND ASPIRATED BY PHACOEMULSIFIER IN
PHACOEMULSIFICATION
o FOLDABLE IOL IS MOST IDEAL WITH PHACOEMULSIFICATION TECHNIQUE.

11. ADVANTAGES OF PHACO OVER SICS.

o TOPICAL ANAESTHESIA MAY BE SUFFICIENT FOR PHACOEMULSIFICATION IN EXPERT


HANDS.
o POSTOPERATIVE CONGESTION IS MINIMAL AFTER PHACOEMULSIFICATION, AS
PHACO IS USUALLY
o SMALL INCISION.
o LESS CORNEAL COMPLICATIONS.
o VISUAL REHABLITATION IS COMPARETIVELY QUICKER IN PHACOEMULSIFICATION
o POSTOPERATIVE ASTIGMATISM IS COMPARATIVELY LESS WHEN FOLDABLE IOLS ARE
IMPLANTED THROUGH A.

12. STEPS OF SICS

o SUPERIOR RECTUS (BRIDLE) SUTURE


o CONJUNCTIVAL FLAP AND EXPOSURE OF SCLERA
o HAEMOSTASIS
o SCLERO-CORNEAL TUNNEL INCISION- 1.5-2 MM BEHIND THE LIMBUS
o SIDE-PORT ENTRY
o ANTERIOR CAPSULOTOMY BY CAPSULORRHEXIS
o HYDRODISSECTION.
o NUCLEUS DELIVERYC
o ASPIRATION OF CORTEX
o IOL IMPLANTATION
o REMOVAL OF VISCOELASTIC MATERIAL
o WOUND CLOSURE

13. HOW IS IOL POWER CALCULATED

IT IS CALCULATED WITH SRK FORMULA.

P=A-2.5L-0.9K

WHERE,

P-CALCULATED IOL POWER

A-IOL SPECIFIC A CONSTANT

L-AXIAL LENGTH OF EYE


14. NAME 3 INTRA OP COMPLICATION DURING CATARACT SURGERY.

o SUPERIOR RECTUS MUSCLE LACERATION


o EXCESSIVE BLEEDING
o INCISION RELATED COMPLICATIONS

15. WHAT IS ENDOPHTHALMITIS? CLINICAL FEATURES?

ENDOPHTHALMITIS IS DEFINED AS AN INFLAMMATION OF THE INNER STRUCTURES


OF THE EYEBALL I.E., UVEAL TISSUE AND RETINA ASSOCIATED WITH POURING OF
EXUDATES IN THE VITREOUS CAVITY, ANTERIOR CHAMBER AND POSTERIOR
CHAMBER.

CLINICAL FEATURES;

OCCURS WITHIN 7 DAYS OF OPERATION AND IS CHARACTERIZED BY SEVERE OCULAR

PAIN, REDNESS, LACRIMATION, PHOTOPHOBIA AND MARKED LOSS OF VISION.

16. TYPES OF IOL BASED ON METHOD OF FIXATION IN THE EYE

BASED ON METHOD OF FIXATION IN EYES


A.ANTERIOR CHAMBER IOL
B.IRIS SUPPORTED LENSES
C.POSTERIOR CHAMBER IOL

17. WHAT IS RIGID IOL MADE OF?

PMMA

GOOD TO KNOW:

18. NAME SOME DRUGS THAT CAN CAUSE CATARACT.

CORTICOSTEROIDS ,AMIODARONES ,PHENOTHIAZINES.

19. WHAT IS THE FORMULA TO CALCULATE IOL POWEROTHER THAN SRK FORMULA?

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