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 Intracapsular Cataract Extraction (ICCE)

Intracapsular cataract extraction is a form of cataract surgery developed in the early 1980s, but seldom used today because more advanced techniques are available. In this surgery, the entire natural lens of the eye, including the capsule that holds it in place, is removed. The procedure requires a much larger incision than used in the more recently developed techniques.

To understand how ICCE works, it is important to understand what a cataract is and how it interferes with vision. The eye works like a camera with two lenses. The first lens is the cornea, a clear membrane that covers the front of the eye. The second lens is the eye's natural crystalline lens, which is held in place by a capsule located behind the pupil (See Anatomy of the Eye).

The cornea is responsible for about 70 percent of the eye's focusing power, while the natural lens fine-tunes the image. When the natural lens becomes cloudy, usually because of the aging process, it keeps light rays from passing through or diffuses the light in such a way that vision becomes fuzzy or hazy. This cloudy lens is called a cataract. The object of cataract surgery is to remove this hazy lens and to replace it with a plastic prescription lens that is permanently implanted in the eye.

When performing intracapsular cataract extraction, the surgeon makes a large opening in the eyeball and injects medicine into the eye, causing the zonular fibers that hold the lens in position to dissolve. A special probe is then placed on the lens, and liquid nitrogen is applied to freeze the lens. As the probe is gently withdrawn from the eye, the natural lens is pulled out with it. Once the natural lens is removed, an intraocular lens implant is inserted in front of the iris, the colored part of the eye. (In the newer form of cataract surgery called extracapsular cataract extractions, the lens is placed behind the iris.) Several stitches are necessary to close the eye until it heals, which may take as long as six weeks.

In addition to the larger incision and accompanying sutures required with intracapsular cataract extraction, the technique also carries a greater risk for retinal detachment and swelling. It is seldom performed today.

Related topics:

See Cataract Examination in Eye Exam Types in Eye Health Center.
See Cataracts in Free Eye Tests.

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