Know Everything About Intracapsular Cataract Extraction

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Intracapsular Cataract Extraction (ICCE)

A cataract is the clouding of the usually transparent eye lens.

According to WHO, cataracts are one of the leading causes of blindness. It accounts for 51% of blindness cases worldwide.

Intracapsular Cataract Extraction (ICCE) is a surgical process used to treat cataracts. This procedure removes the lens and the thin capsule surrounding it.

ICCE was prevalent till the 1980s, after which Extracapsular Cataract Extraction (ECCE) became the norm.

The clouded lens is removed in ECCE, but the capsule is left intact.

Like other cataract surgeries, ICCE aims to restore clear vision. 

But this procedure has become archaic due to the large incision required and the pressure on the vitreous body.

However, it is still performed in countries where operating microscopes and high technology are rare.

In this article, you will learn more about intracapsular cataract extraction surgery. Please continue reading about Intracapsular Cataract Extraction (ICCE), its preparation, steps, and aftercare.

Did you know:
Nowadays, there are three major types of Cataract surgeries:

  • Phacoemulsification
  • Extracapsular Cataract Extraction (ECCE)
  • Femtosecond Laser-assisted Cataract Surgery (FLACS)
  • Preparation

    The surgery is typically performed as an inpatient procedure.

    Check with your doctor, as it can also be performed as an outpatient procedure. It will depend on your condition and needs.

    Here are some things that are done before ICCE:

    cataracts vs glaucomaSource: y_yacobchuk_from_Getty_Images
    eye checkup
    • An eye examination is performed before the surgical procedure
    • The medical professional will perform an ultrasound to ensure the retina is in good condition
    • The ultrasound also measures the curvature of the eye. It will help to get an accurate Intraocular Lens (IOL) prescription
    • The doctor will look for infections such as Blepharitis, Conjunctivitis, and Nasolacrimal obstruction
    • A preoperative physical examination is required to rule out any diseases that could complicate the surgery
    • The doctor will prescribe antibiotic eye drops or an ointment a day before the surgery

    Procedure for Intracapsular Cataract Extraction (ICCE)

    cataract surgery side effectsSource: loonger_from_Getty_Images_Signature
    Intracapsular Cataract Extraction

    An Intracapsular Cataract extraction has the following steps:

    • Before the start of the procedure, the ophthalmic assistant gives the patient a mild sedative to help with relaxation. They numb the eyes with local or general anesthesia
    • To prevent blinking, your doctor will use a speculum to keep the eyelid open
    • The surgeon applies pressure to the eyeball while massaging it to reduce vitreous volume and prevent a bulge
    • After that, the doctor will prepare the skin in the operative area of the eye with a topical anti-infection agent
    • The surgeon makes an incision in the limbal area, which is the intersection of the sclera and the cornea
    • A medication is injected into the eye, softening the fibers that hold the lens in place
    • The surgeon smears liquid nitrogen on the lens with a probe to freeze it. They will use the probe to lift the cornea and remove the lens capsule and cataract
    • After that, they remove the entire natural lens and the capsule that holds it
    • Once removed, an IOL is placed in the front of the iris. They will stitch the wound to keep the eye closed until it heals

    As the vitreous and zonules are attached to the lens, ICCE is more difficult in young patients.

    The surgeon injects an enzyme into the lens zonules area to break up the attachments. 

    People aged 30 to 60 can successfully undergo the procedure.

    Aftercare

    After the procedure, you may be unable to use your eyes, so you should have a friend or relative drive you home.

    Your doctor may inject medications, usually steroids, and antibiotics, into the operated eye before you leave the clinic.

    Avoid heavy lifting or extreme bending. You can resume normal activities within one to two days of surgery.

    The doctor may recommend that you wear their glasses during the day and tape an eye shield over your eye at night.

    Wear sunglasses on and avoid rubbing or bumping the operated eye.

    You must also take care of your sleeping position after a Cataract surgery.

    In addition, for two to three weeks, the ophthalmologist will prescribe eye drops to prevent infection, manage pain, and reduce swelling.

    It would be beneficial if you used these eye drops as directed.

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    Complications

    Like another surgical procedure, ICCE, too, has some complications. 

    Per a study, post-operative Glaucoma is the most common complication after ICCE.

    Here are a few complications of this cataract surgery:

    • Retinal detachment 
    • Hyphema 
    • Rapture of the capsule and loss of vitreous gel 
    • Dislocated or decentered IOL
    • Central retinal inflammation or macular edema 
    • Choroidal hemorrhage
    • The residue of small lens pieces in the back of the eye
    • Intraocular infection or endophthalmitis 
    • Corneal edema 
    • Posterior capsule opacity
    • Corneal astigmatism 
    • Cystoid macular edema 

    Conclusion

    Intracapsular Cataract Extraction (ICCE) is a surgery for removing the clouded lens and the capsule surrounding it.

    It has become obsolete with the introduction of other methods, such as ECCE. 

    Because of the large incision required and the pressure placed on the vitreous body, the procedure is rarely performed.

    However, it is still performed in countries where operating microscopes and high-technology equipment are not available.

    Warning
    Check with your doctor before deciding on a treatment for your cataract. They will recommend the best surgery depending on the severity and your health.

    Frequently Asked Questions

    What is intracapsular cataract extraction?

    Intracapsular cataract extraction is the removal of the lens and the surrounding capsule. The procedure has a high rate of complications due to the large incision required and the pressure placed on the vitreous body.

    How does intracapsular extraction work?

    Intracapsular cataract extraction (ICCE) involves removing the lens and the surrounding capsule in one piece. The lens is then replaced with an artificial lens (IOL) which remains permanently in the eye.

    Why is ICCE not done?

    Intracapsular cataract extraction has a high risk of complications due to the large incision required and the pressure on the vitreous body. It is rarely performed in developed countries.

    Citations:
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