I. Intracapsular Cataract Extraction
- Presently, the technique of intracapsular cataract extraction (ICCE) is obsolete.However, the surgical steps are described here as a mark of respect to thetechnique which has been widely employed for about 100 years over the world and is an important landmark in the history of cataract surgery.
I Surgical steps of the ICCE technique I
- Superior rectus (br;d/e) suture: It is passed to fix the eye in downward gaze.
- Coniunctival flap (fornix based):
- It is prepared to expose the limbus and haemostasis is achieved by wet field or heat cautery.
- All surgeons do not make conjunctiva! flap.
- Partial thickness groove or gutter:
- It is made through about two-thirds depth of anterior limbal area from 9.30 to 2.30 O’clock (150°) with the help of a razor blade knife.
- Corneoscleral section:
- The anterior chamber is opened with the razor blade knife· or with 3.2 mm keratomeand section is completed using sclerocorneal scissors.
- lridectomv:
-A peripheraliridectomy may be performed by using iris forceps and de Wecker’s scissors to prevent postoperative pupil block glaucoma.
- Lens delivery: In ICCE, the lens can be delivered by any of the following methods:
- Smith method:
- Here the lens is delivered with tumbling technique by applying pressure on limbus at6 O’clock position with lens expressor and counterpressure at 12 O’clock with the lensspatula.
- The lens would “Tumble”, i.e. lower pole is delivered first.
- Cryoextracfion:
- In this technique, tip of the cryoprobe is applied on the anterior surface of the lensin the upper quadrant.
- Freezing is activated (-40°C) to create adhesions between t e lens and the probe.
- The zonules are ruptured by gentle rotatory movements and the lens is thenextracted out by sliding movements.
– I n this technique, upper