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PHACOEMULSIFICATION (watch the videos) The cataract surgical treatment is undoubtably one of the most advanced steps performed by the medical technology. In fact, nowdays it is possible to remove it through such a small hole that there is no need to fill it up. This technique is called PHACOEMULSIFICATION and it is performed crushing and following suction of the cataract material through a small probe, having the size of the point of a roller-ball and exploiting the mechanical power of ultrasounds. This probe is introduced inside the eye through a "tunnel" passage in the ocular tissue having a wideness of about 3.5 mm; as a result of these small sizes and of its structural characteristics, this "tunnel" is self-healing, and therefore no stitches are needed for overlapping the wound. However, in some cases, we take the decision to suture a stitch at the end of operation in order to be able to "reduce" the post-operation astigmatism as much as possible, reaching a final result of the operation more and more satisfactory for the patient. In any case the advantages of this method are the following:

Interocular Lens (IOL)

Once removed the crystalline affected by cataract, the installation of a so called artificial cristallyne or IOL will be needed. But this crystalline has not the same features of the natural one which can change its thickness, thus allowing both distance and near sight and therefore it can only allow the sight of one of them. For this reason, in most of cases, it is calculated for being allowed to perform the relationships life that is for distant sight; for reading, auxiliary lens will be necessary (presbiopia lens). The calculation of the crystalline "degree" is performed during the specialistic examination by an instrument called ECOBIOMETER. This equipment allows to measure by means of ultrasounds, the eye length in order to evaluate the "power" needed by the crystalline to be installed.

Folding interocular lens

The real size of a lens compared with a common paper clip

Even the IOL manufacturing industry is undertaking an important progress. In fact the interocular lens utilized after cataract removal by phacoemulsification are smaller than the ones previously adopted, or they are SOFT IOL, to be introduced folded because, thanks to their structural features, they open inside the eye. This kind of lens fully exploits the phacoemulsification advantages because it is not necessary to enlarge the previous hole for removing the cataract. But the most advanced technology is the MULTIFOCAL IOL, that is an artificial crystalline that allows both far and near focusing, an effect that can be compared to a "multifocal" lens. But the installation of this kind of crystalline has some limits. Above all, an almost contemporary "bilateral" operation is needed, in order to implement its use, and therefore it can be installed to the patients whose eyes are both affected by cataract. Besides that, it is not recommended to the old patients because they cannot fully exploit its power, and to the myopic patients or to the patients affected by other ocular pathologies.

Operation and Anesthesia

The cataract operation time is very short (about fifteen minutes) and therefore 95% of cases are operated under local anesthesia. This means that only the eye is "narcotized" while the awake patien speaks with the surgeon without any pain.
This kind of anesthesia can be performed either injecting the anaesthetic through an insulin syringe needle into neighbouring part of the eye to be operated (eyeball anesthesia) or instilling some simple drops (topical anesthesia). Through the first proceeding the patient only feels a very small pick sensation similar to the one produced by an insect; through the second proceeding, which can only be adopted thanks to the invention of phacoemulsification, he does not feel any sensation. Both methods allow the patient to stand up immediately after the operation and to go home. The general anesthesia is only adopted for particular cases such as babies or young patients and whenever it is not possible to obtain any co-operation in cases of patients affected by mental diseases.