Typical Cataract Surgery (Part 2 of 4)

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