Typical Cataract Surgery (Part 2 of 4)
0 (0 Likes / 0 Dislikes)
Hello again. This is Dr. David Richardson, the "Cataract Coach"
and this is part two of our four part video
of an
actual cataract surgery.
So, now what I'm doing is
I'm getting ready to actually start the ultrasound
You'll see that my assistant is constantly
watering, or keeping the corneal surface moist, so that II have a nice clear view
Now on the edge of this you see the ultrasound tip.
That is the ultrasound device that I'm going to use to remove the cataract.
The tip actually moves very very quickly,
at speeds faster than that of sound.
and the pink sleeve around it is actually irrigating fluid into the eye
and that keeps the eye formed along with the viscoelastic gel.
I use a technique called horizontal chopping.
I use a second instrument - that's the titanium instrument that you see
at the top of the screen.
That instrument allows me to move
the cataract and separate it into fragments
which I then lead toward the phacoemulsification tip
and the tip, as you can see, is emulsifying. It's taking those fragments
and essentially
just cutting them
up into tiny little pieces and then it's vacuumed out though that very tip
It's really an incredible process. We have the late doctor Charles Kelman
To thank for that
an absolutely
brilliant man
who realized one day in his dentist's office
that the same technology that was used for cleaning teeth could
be used to remove cataracts.
So how's that for thinking outside of the box
As you can see here the phacoemulsification
is going on and this part of the surgery
although it's the bulk of the surgery
does not take as long as all of the the preparatory steps
Now what I'm doing is removing what's called the "epinucleus"
that's the soft layer that I created by the hydrodilineation step
and this rolls up into the tip. This is actually a relatively
risky step because
this is very very soft and if
it gets vacuumed up
too quickly
the capsule is right on the other side of it
and the phacoemulsification tip can actually cut a hole in the capsule.
Remember it is very very small
So I actually use my second instrument
and position it between
the tip of the ultrasound
and the capsule, itself
This is one of the advantages of using a second instrument
Now as you can see as the epinucleus is being removed
you get a nice
what we call a "red reflex"
You're actually seeing the reflex off of the retina but you can't see the retina itself.
Now you'll notice it's pretty clear except for over on the side you see
a little bit of haze. That's what we called the "cortical material"
All right, that's it for
session two of our four part series.
Next we will go over the removal of the cortex.
www.David-Richardson-MD.com