Phakoemulsification cataract extraction with foldable IOLs-first 50 cases.

Abstract

Phakoemulsification as a procedure is only complete with flexible foldable lens. Preliminary studies show good acceptance of the procedure though the injector is cumbersome. Phakoemulsification has now become a reality with advanced instrumentation techniques available. Phakoemulsification has to its greatest advantage the ability to remove a cataract though a 3mm opening. Not only does this enhance the safety and the speed of healing, but it reduces postoperative astigmatism significantly. However, the very advantages listed above stand negated if the wound is to be opened to 6mm to accommodate an implant. The extra effort needed as compared to regular extra capsular cataract extraction, the enhanced cost of the instrumentation, the more sophisticated technique needed and the superior magnification devices required were all rendered negative till the flexible lenses made their debut. With foldable lenses, phakoemulsification has come into its own. Thomas Mazaco was first credited with the concept of folding and inserting lenses. The ocular lenses were foldable with a forcep (Faulker Folder) and inserted into the eye through a 4 mm incision. It was a tight fit and the compression exerted by the forceps often left a bend on the lens. These problems led to the manufacture of a injective inserter which was in essence a single metal syringe with a piston, either longitudinal pressure or screw movement. Of these the Bartel injector was perhaps the earliest. Now virtually every company making flexible lenses has come out with an injector. The Staar Softrans injector has proven in my hands to be the most useful of all these devices.