Phacoemulsification

Under phacoemulsification (of gr. Phakos (eye) lens ) is meant the crushing and extraction of the lens nucleus by means of an excited with ultrasonic needle and then aspirating the debris by means of a Saugspülvorrichtung. Phacoemulsification is the most common technique of surgical treatment of cataracts (cataract). With an estimated 600,000 to 800,000 operations in Germany in 2008, it is one of the most frequently performed operations. A further increase in the number of cases is expected due to the age structure.

In extracapsular cataract extraction, as it was fundamentally developed by Jacques Daviel from 1745 and was first performed in Berlin in 1755 by the military surgeon Jacques Taverne , the posterior lens capsule remains and only a central hole is carved into the anterior capsule; in contrast, the z. B. Intracapsular cataract extraction, which is widespread in developing countries, removes the lens together with the capsule. This procedure is faster, cheaper, and technically simpler, but it has more serious complications.

After the lens has been removed, its refractive power must be compensated either by inserting an intraocular lens or using glasses . A posterior chamber lens is usually used today; often postoperatively - when both eyes have been operated on - glasses are no longer necessary. However, the operated eyes lose their ability to accommodate . Should it be necessary to adjust the glasses, this will be done about three to four weeks postoperatively. During extracapsular cataract extraction, the proliferation of remaining lens epithelial cells can form a dense membrane behind the artificial lens ("secondary cataract "), which can be removed again by laser treatment (YAG laser capsulotomy).

Individual evidence

1. ↑ Aqua-Institut, Cross-Sectoral Quality Assurance in Health Care (PDF; 962 kB) Cataract Surgery, Final Report October 18, 2010, Section 2.3.1, accessed on May 16, 2014
2. ↑ Aloys Henning: On the paradigm shift in cataract surgery, especially in Berlin from 1755. In: Würzburger medical history reports. Volume 18, 1999, pp. 271-296; here: pp. 271 and 286–289.

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