Phacoemulsification with IOL

Why are we operating?

The most performed operation on earth: the clouded lens is emulsified through a two-millimetre tunnel and a folded acrylic lens unrolls into its place.

Indication: Visually significant cataract; the threshold is the patient's life, not a Snellen line.

The operation in 4 steps

1. 01Incisions and capsulorhexis

   Self-sealing corneal micro-incisions, viscoelastic fills the chamber, then a continuous circular tear is fashioned in the lens's anterior capsule.

   Why: The capsulorhexis is the operation's signature move: a smooth continuous circle resists tearing outward under every later force, and the intact capsular bag it creates is where the new lens must sit for the rest of the patient's life.

2. 02Emulsifying the nucleus

   After hydrodissection frees the nucleus, the ultrasonic tip divides and emulsifies it piece by piece, aspirating as it goes.

   Why: Ultrasound turns a lens too big for the incision into an emulsion that leaves through a needle. The posterior capsule waits a millimetre behind every manoeuvre, which is why machine settings and chamber stability are the craft.

3. 03Cortex removal and lens implantation

   Soft cortex is aspirated, the bag re-inflated with viscoelastic, and the folded intraocular lens injected to unfold into the capsular bag.

   Why: The IOL's power was calculated for this eye before surgery; centred in an intact bag it restores focus for decades. The bag is the reason every earlier step protected the capsule.

4. 04Sealing and after

   Viscoelastic is exchanged out, incisions hydrated to self-seal, intracameral antibiotic given; drops and review complete the pathway.

   Why: Retained viscoelastic spikes pressure overnight; unsealed wounds invite the rare but blinding endophthalmitis. The operation's last minutes defend against both of its worst sequels.

Anatomy you need

The globe and its lens: the operation works through a 2 mm corneal tunnel in what you are looking at.

What can go wrong

• Surgical-site infection

  Wound erythema, warmth, discharge, and pain out of proportion, typically from postoperative day 4–7.