Lucky? Unlucky?
I guess it works both ways. Felt bad for the patient though.
She's a 70+ y/o, came in for a cataract surgery.
However, the method used wasn't phacoemulsification.
Extracapsular cataract extraction (ECCE) was preferred over phaco for her case.
Phaco is only done in those w less opaque or dense lens. A bad cataract which is totally opaque would automatically be removed using ECCE.
It is said that phaco would fail on a dense lens.
Compared to phaco where u get 2 tiny little scars requiring no sutures, ECCE is the removal of the lens without breaking it down.
Therefore, a larger incision is needed.
However during the procedure, after insertion of the lens, the lens doesnt stay in place. It somehow sinks.
Thats when they start to notice that actually the posterior capsule of the lens is ruptured. The posterior capsule is not removed in modern cataract surgery as it acts as a bag for the artificial lens.
Surgery prolonged, restless patient, some not-so-happy doctors. Patient's restless, u can see her moving her lower limbs around, the eyeball too.
And occassionally some instruction from the doctors to tell the lady not to move her eyes.
Once it's ruptured, the vitreous from the eye will ooze out into the anterior chamber of the eye which is located in front of the lens.
The anterior chamber only contains aqueous. Once the vitreous enters the anterior chamber, it can clog up the trabecular meshwork, causing it to slow down the removal of aqueous indirectly causing a higher pressure in the anterior chamber and glaucoma.
The vitreous is actually very mucus like. Therefore if u pull some of the vitreous out, it will also pull out the remaining vitreous at the back.
So in order to remove it, vitrectomy must be performed. Vitrectomy sucks the vitreous out but at the same time cuts it too to avoid pulling out the vitreous at the back.
Cutting rate is at about 100+ per minute.
However there's still loss of vitreous. Loss of vitreous is usually associated with retinal detachment, another more serious cause of vision loss.
Well, what's happened already happened. The specialist say that actually the risk of posterior capsule rupture is the same in both ECCE and phaco.
He also mentioned that any small mistakes can cause the capsule to rupture. It's a fragile structure.
Too bad for her, I hope she recovers well, without any further complications.
2 comments:
oh my goodness... i feel so sorry for her. she might lose her vision? gosh...
well, every surgery has its own risk, there's no 100% perfect. and i believe doctors had already did their very best as no doctors would want their patient to suffer.
i guess she still has another eye with her rite? at least she can still see. that's why we are born with 2 eyes. ^^
to look at the bright side, here's something for her.
when the window to our heart closes, the door of our heart opens. our vision become clearer because that's the time we use our heart to see. ^^
i think her vision would still be there. she's just at higher risk for other causes of vision loss.
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