Cataract Surgery
ICCE intracapsular cataract surgery - lens with capsule removed
ECCE lens removed and much of lens capsule left in place
Manual or planned ECCE done with expression of nucleus through large incision
Phacoemulsification uses ultrasound energy to break up the nucleus through small incision
Pars plana lensectomy (PPLx) posterior approach by retinal surgeons often at time of vitrectomy
Method Indications Advantages Disadvantages
ICCE Poor zonular support No risk of secondary cataract
Little instrumentation needed 		High risk vitreous loss (20%)
Astigmatism
Delayed visual rehabilitation
Contraindicated in children
Only ant chamber or sulcus fixated IOL
ECCE Very hard lens
Poor K endothelium 		Less instrumentation needed
Easy on corneal endothelium
Allows post chamber IOL 		Astigmatism
Delayed visual rehabilitation
Phaco Most cataracts Fast visual rehabilitation Expensive instrumentation
Ultrasound is hard on corneal endothelium
PPLx Poor zonlular support
During vitrectomy 		Right surgeon present if lens goes south Expensive instrumentation
May loose all zonular support


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