Nowoczesne metody operacji zaćmy
Modern Techniques of Cataract Surgery
Anna Kamińska, Justyna Izdebska, Edyta Zielińska, Marta Szymańska-Świderska, Jacek P. Szaflik
Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademii Medycznej w Warszawie Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie Kierownik: prof. dr hab. n. med. Jerzy Szaflik
Summary: Cataract is the leading cause of reversible blindness in the world. The most effective and common treatment is surgical removal of the cloudy lens. There are two types of surgery that can be used for cataract removal: intra-capsular (ICCE) and extra-capsular (ECCE).The last one includes phacoemulsification. Torsional ultrasound is a new phacoemulsification technology that uses ultrasonic oscillatory movement. Compared with the forward-and-backward motion of the traditional ultrasound tip, the side-to-side motion of the torsional phaco tip provides reduced repulsion and improved thermal safety, which is an extremely important factor when working with hard cataracts. The lower flow and reduced vacuum enhance protection of corneal endothelium. In the last few years ultrasound phacoemulsification enabled lens extraction through an incision of less than 2.0 mm (Small Incision Cataract Surgery). In micro incision cataract surgery (MICS) an incision is less than 1.5 mm. MICS provides advantages of wound stability, improved control and reduced chamber turbulence, resulting in very small induced astigmatism, early visual rehabilitation and improved results. With the advance of foldable IOLs, lenses can be implanted through the same small incision that is created in the phaco procedure. These IOLs are made of a flexible material allowing them to be folded for implantation using injector. Nowadays bimanual phacoemulsification connected with MICS and IOL implantation is currently the method of choice in cataract surgery.