Manual of Practical Cataract Surgery R Sundararajan
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1Manual of Practical Cataract Surgery
2Manual of Practical Cataract Surgery
R Sundararajan MS DO Professor Emeritus in Ophthalmology The Tamilnadu Dr MGR Medical University, Chennai Consulting Surgeon, Madurai City Hospital Madurai, Tamil Nadu, India Formerly Professor and HOD in Ophthalmology Madurai Medical College, Madurai Professor of Ophthalmology Vinayaka Medical College, Salem PG Institute of Ophthalmology Dr Joseph's Eye Hospital, Trichy Tamil Nadu, India
3Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Manual of Practical Cataract Surgery
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2009
9788184486056
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset & Packagings Ltd New Delhi4
To
My Father whose life-long ambition to make me a well-educated individual…
and
My Mother whose life-long prayers till her death to provide me excellent education…
Have provided me the strength to bring out this work
5Preface
Though many books are already available in the market, I am introducing this book, with a view to simplify the procedures so that beginners can easily learn doing Manual Phaco (SICS). For high volume surgeries, this procedure is the usual choice as it requires minimum instruments and minimum time.
When I had an opportunity to visit some Eye Hospitals, I saw students doing planned ECCE with IOL and have either not done or scared to do Manual Phaco.
All beginners of cataract surgery are bound to commit mistakes causing complications which can either be easily rectified or the eye is lost.
An attempt has been made to avert complications by making the beginners to understand how each and every step produces the desired or undesired effect.
To master the technique of Manual Phaco procedure, one has to be thoroughly oriented with the planned ECCE (Extra Capsular Cataract Extraction) with IOL. This is why this section is also incorporated in this book. In addition, capsulorhexis procedure is explained with the help of easy drawings. In case, the Rhexis is smaller or irregular, a rectifying method of the procedure is also furnished in an easily understandable magnified drawings. SICS is a poor man's Phaco emulsification procedure.
If one is thorough with this capsulorhexis and other basic procedures, it would be easy for the individual to start the phaco emulsification procedures and Micro Phaco procedure, which requires costly equipments and more of an institutional procedures.6
Though various lectures and CME (Continuing Medical Education) techniques and other methods had been instituted at various centres, I have made this contribution which will be useful to understand still more in detail on seeing the drawings.
Similarly, a topic on Squint is also incorporated though not inter-related. Most of the Ophthalmologists are interested in mastering the basic techniques of cataract surgeries only, giving least importance to Squint.
An attempt has been made in this book to make the beginners understand Squint easily.
R Sundararajan
7Acknowledgements
The main portion of this subject was gathered from the files I maintained from my own surgeries and management of complications after IOL surgeries.
I am immensely grateful to Dr Rajasekaran, Chairman, Dr Joseph's Eye Hospitals, for the great opportunity provided to me to handle plenty of cases of orbit and IOL cases.
I am grateful to Dr Nelson Jesudasan, Director, PG Institute JEH, Trichy, for the valuable permission and encouragement to bring out this small book.
My grateful thanks are due to my friendly colleagues, Dr Rajmohan, Dr Ramalingam and Dr Shibu, who used to come forward to help me at the time of distress.
I am thankful to my close friend Prof K Kannan, who permitted me to use his printing instruments and also his staff Mrs Ramiza for typing. The preliminary drawings were done by me.
I am indebted to Shri Jitendar P Vij (Chairman and Managing Director), Mr Tarun Duneja (Director-Publishing), Mr KK Raman (Production Manager) and Ms Samina Khan (PA to Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for publishing the book. I am also thankful to Mr Jayanandan, Senior Author Coordinator (Chennai Branch) who encouraged me a lot to finish my work by his frequent contacts.