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Untitled Document
Extracapsular cataract extraction (ECCE) is a category of eye surgery in which the lens of the eye is removed while the elastic capsule that covers the lens is left partially intact to allow implantation of an intraocular lens (IOL). This approach is contrasted with intracapsular cataract extraction (ICCE), an older procedure in which the surgeon removed the complete lens within its capsule and left the eye without a lens. The patient's vision was corrected after intracapsular extraction by extremely thick eyeglasses or by contact lenses.
There are two major types of ECCE: manual expression, in which the lens is removed through an incision made in the cornea or the sclera of the eye; and phacoemulsification, in which the lens is broken into fragments inside the capsule by ultrasound energy and removed by aspiration.
In extracapsular cataract extraction, the surgeon makes a tiny incision in the white of the eye near the outer edge of the cornea. The size of this opening depends on whether the nucleus of the lens is to be removed all in once piece or whether it will be dissolved into tiny pieces and then vacuumed out (phacoemulsification). The surgeon then enters the eye through this incision and carefully opens the front of the capsule that holds the lens in place. After the nucleus or hard center of the lens is removed, the soft lens cortex is suctioned out, leaving the back of the capsule in place in order to strengthen and support placement of the intraocular lens.
The risks of extracapsular cataract extraction include:
- Edema (swelling) of the cornea.
- A rise in intraocular pressure (IOP).
- Uveitis ,which refers to inflammation of the layer of eye tissue that includes the iris.
- Infection of the external eye may develop into endophthalmitis, or infection of the interior of the eye.
- Hyphema , which refers to the presence of blood inside the anterior chamber of the eye and is most common within the first two to three days after cataract surgery.
- Leaking or rupture of the incision.
- Retinal detachment or tear.
- Malpositioning of the IOL. This complication can be corrected by surgery.
- Cystoid macular edema (CME).
The macula is a small yellowish depression on the retina that may be affected after cataract surgery by fluid collecting within the tissue layers. The patient typically experiences blurring or distortion of central vision. CME rarely causes loss of sight but may take between two and 15 months to resolve completely.
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