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Cataract surgery by “couching” (lens depression) is one of the oldest surgical procedures. The technique involves using a sharp instrument to push the cloudy lens to the bottom of the eye. Perhaps this procedure is that which is mentioned in the articles of the Code of Hammurabi (ca. 1792–1750 BC) though it is a mere speculation.
Complications after cataract surgery are relatively uncommon. Posterior vitreous detachment (PVD) may occur but does not directly threaten vision. [23] Some people develop a posterior capsular opacification (PCO), also called an after-cataract. This may compromise visual acuity, and can usually be safely and painlessly corrected using a laser.
Months or years after the cataract operation, the remaining posterior lens capsule can become opaque and vision will be reduced in about 20–25% of eyes. [4] This is known as posterior capsule opacification (PCO). PCO is best treated by posterior capsulotomy using YAG laser. [4]
Cataract surgery is the most common application of lens removal surgery, and is usually associated with lens replacement. It is used to remove the natural lens of the eye when it has developed a cataract, a cloudy area in the lens that causes visual impairment. [4] [10] Cataracts usually develop slowly and can affect one or both eyes. [4]
Posterior capsular opacification, also known as after-cataract, is a condition in which months or years after successful cataract surgery, vision deteriorates or problems with glare and light scattering recur, usually due to thickening of the back or posterior capsule surrounding the implanted lens, so-called 'posterior lens capsule opacification'.
In intra-capsular cataract extraction (ICCE), the whole lens including the anterior part of the capsule is removed. During more common extra capsular cataract surgery procedures like micro incision cataract surgery, phacoemulsification etc., the clouded lens is removed through an opening made in the anterior lens capsule. [23]
After being used regularly for centuries, couching has been mostly abandoned in favour of more effective techniques, due to its generally poor outcomes, and is currently only routinely practised in remote areas of developing countries. [11] [12] Cataract surgery was first mentioned in the Babylonian code of Hammurabi 1750 BCE. [13]
A Cochrane Review seeking to determine whether glaucoma surgery combined with cataract surgery via phacoemulsification has any advantages over cataract surgery (via phacoemulsification) alone, found that eyes that underwent combined (glaucoma and phacoemulsification) surgery had a significantly lower intraocular pressure (-1.62 mmHg) compared ...