Extracapsular Cataract Surgery

Although phacoemulsification has become the preferred method of cataract surgery, conventional or standard Extracapsular Cataract Extraction (ECCE) is considered less risky for patients with very hard cataracts, because the ultrasound energy used during Phacoemulsificaion tend to stress the intraocular tissues, increasing the risk of intraoperative and postoperative complications.

ECCE is one of the safest and most successful procedures in contemporary eye surgery; about 95% of patients report that their vision is substantially improved after the operation.

A conventional extracapsular cataract extraction takes less than an hour to perform. After the area around the eye has been cleansed with antiseptic, sterile drapes are used to cover most of the patient’s face. The patient is given either a local anesthetic to numb the tissues around the eye and the eye itself. An eyelid holder is used to hold the eye open during the procedure. After the anesthetic has taken effect, the surgeon makes a 10-12mm incision in the cornea at the point where the sclera and cornea meet. After the incision is made, the surgeon then carefully opens the lens capsule and removes the hard nucleus of the lens by applying pressure with special instruments. After the nucleus has been expressed, the surgeon uses suction to remove the softer cortex of the lens. A special viscoelastic material is injected into the empty lens capsule to help it keep its shape while the surgeon inserts the IOL. After the intraocular lens has been placed in the correct position, the viscoelastic substance is removed and the incision is closed with some stitches. The stitches are kept in place for at least 3 months. During that time, the vision uses to be better than before the surgery but it is not totally clear. Once the stitches are removed by the doctor, the final glasses prescription is determined and the vision gets restored as much as possible.