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Typical Cataract Surgery (Part 1 of 4)

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Hello. This is Dr. Richardson (also known as The Cataract Coach online) Today I would actually like to show you a full cataract surgery in real time You'll notice that the length of this video is just under fourteen minutes and that is the length of the surgery and the surgery was not rushed. This video has not been edited. It is from beginning to end. So let me go ahead and discuss what I'm doing here You just saw me making two small one millimeter incisions in the cornea at what we call the limbus that's as I can gain access to the inside of the eye next I place a viscoelastic solution (that's a special gel used to keep the eye formed and to protect the cornea The inside cells of the cornea are the ones that keep it clear so it's important to protect them now I'm placing them mark on the cornea itself I will use that mark later to allow me to size the capsulorrhexis tear (we'll speak about that). Right now I'm creating an incision in the temporal aspect of the side of the cornea. The incision is only 2.2 millimeters in width This now is the most stressful part of the surgery for most surgeons especially resident surgeons learning how to do cataract surgery. This involves making a tear in the capsule The capsule is a transparent membrane and is only a few millionths of a meter thick. It's very hard to see here but I think you can get the idea that I'm tearing a circle in the capsule. We call this a continuous curvilinear capsulorrhexis and I use special forceps that are made for it. I find that the forceps give me more control although some surgeons use what is called a "bent-needle cystitome" which is essentially a needle with a bend on the end of it. I'm actually using the mark that I made on the cornea earlier to guide me and the reason for that is is not that I need to know what a circle looks like but the size of the circle is important. I've just removed the capsule that I tore there. The capsullorrhexis should be just a little bit smaller then the diameter of the optic of the lens that is going to be put in there Now what I'm doing is called "hydrodissection" I create a fluid wave around the cataract and beneath the capsular edge and what this does is it frees up the cataract I also do what's called "hydrodileneation" which creates a layer between the inner dense part of the cataract and fluffier outer layer of the a cataract. So it is kind of like a creampuff except that the inside is dense instead of puffy. Next will be the actual removal of the cataract (or "phacoemulsification" as we call it). Take a look at at part two of this four-part series on cataract surgery and how it's done

Video Details

Duration: 3 minutes and 53 seconds
Country: United States
Language: English
Producer: David D. Richardson, M.D.
Director: David D. Richardson, M.D.
Views: 74
Posted by: cataractcoach on Mar 16, 2010

(1 of 4) Harvard-trained Los Angeles and Pasadena area eye surgeon, David D. Richardson, M.D. (a.k.a. "The Cataract Coach" describes modern cataract surgery in real time.
(626) 289-7856

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