Phacoemulsification (PHACO) is the gold standard microsurgical method used today for the treatment of cataracts, which is known as the loss of transparency of the eye's natural lens. Based on the principle of breaking down and aspirating the clouded lens with the aid of ultrasonic energy and replacing it with an artificial intraocular lens, this technique offers a small incision, rapid recovery, and excellent visual outcomes. As one of the most successful applications of modern ophthalmic surgery, PHACO surgery enables millions of people to regain their quality of vision. This method, which is easily preferred by patients due to its short surgical duration, the ability to be performed under local anesthesia, and its nature as an outpatient procedure, can even offer the possibility of clear vision without glasses when combined with advanced intraocular lens technologies.
What is Phacoemulsification and How Does It Work?
Phacoemulsification is derived from the combination of the words "phaco" (lens) and "emulsification," meaning the emulsification of the lens. In this method, a small incision of only 2-3 millimeters is made in the eye, and the tip of a special device (phaco probe) is inserted into the eye through this incision. The cataract is broken down by high-frequency ultrasonic vibrations and simultaneously aspirated and removed from the eye. Being much less invasive than classic extracapsular cataract surgery, this method allows for rapid recovery of vision post-surgery through a small, sutureless incision. The artificial lens placed in its stead assumes the function of the natural eye lens and remains in the eye for years.
Working Principle
The working principle of PHACO surgery consists of several basic steps:
- Creating a micro-incision: A 2-3 mm surgical window is opened in the cornea.
- Capsulorhexis: A circular opening is created on the anterior surface of the lens capsule.
- Hydrodissection: The lens is separated from the capsule using fluid.
- Ultrasonic fragmentation: The phaco probe breaks down the lens nucleus with vibration.
- Suction and aspiration: The fragmented lens is aspirated and removed through the same channel.
- Cortical cleanup: Soft tissue remaining in the lens capsule is carefully cleaned.
- Lens implantation: A foldable intraocular lens (IOL) is inserted through the small incision.
- Incision closure: In most cases, sutures are not required; the incision closes spontaneously with fluid filling.
In Which Cases Is It Applied?
Phacoemulsification is primarily used in the treatment of the following conditions:
- Senile cataract: The most common age-related type of cataract.
- Congenital cataract: Lens clouding present from birth.
- Traumatic cataract: Cataract developing after eye injuries.
- Diabetic cataract: Early-onset cataract seen in diabetic patients.
- Drug-induced cataract: Especially related to long-term cortisone use.
- Secondary cataract: Lens clouding accompanying other eye diseases.
- Refractive lens exchange: Permanent vision correction for high myopia or hyperopia.
- Presbyopia treatment: Correction of near vision with multifocal and trifocal lens implantation.
- Uveitic cataract: Cataract caused by intraocular inflammation.
- Post-traumatic cataract: Lens clouding developing after old eye traumas.
Advantages of Phacoemulsification
The clinical advantages offered by this modern surgical method are quite comprehensive:
- Very small surgical incision: Minimally invasive approach with a 2-3 mm sutureless incision.
- Rapid visual recovery: Most patients begin to see clearly on the first day after surgery.
- Local anesthesia: Can be performed without the need for general anesthesia.
- Short surgical duration: Usually completed within 15-20 minutes.
- Outpatient procedure: The patient is discharged on the same day.
- Low risk of complications: Modern techniques have reduced complication rates to very low levels.
- Astigmatism correction: Astigmatism can also be treated with premium lenses.
- Refractive correction: Possibility of vision without glasses with multifocal lenses.
- Non-recurring treatment: It is not possible for the cataract to recur after surgery.
- Active life: The patient can return to daily activities within a few days.
- High success rate: Success rates over 98% are achieved with the correct indication.
Treatment Process
Before PHACO surgery, a comprehensive eye examination is performed on the patient. Visual acuity, intraocular pressure, corneal measurements (biometry), pupil examination, and retinal evaluation are completed. The appropriate lens type (monofocal, multifocal, toric, trifocal, EDOF) is determined based on the patient's lifestyle and visual expectations. Lens selection is made according to whether the patient desires distance vision without glasses or both near and distance vision. On the day of surgery, topical anesthesia is applied to the patient, and mild sedation is given if necessary. The procedure is completed in 15-20 minutes under a microscope in the operating room. During the surgery, the patient is completely painless and conscious, feeling only light and movement. After the surgery, the patient is discharged after resting for about 1-2 hours. The first check-up is performed the next day, and subsequent check-ups are planned for the 1st week, 1st month, and 3rd month. Post-operative antibiotic and anti-inflammatory drops are used for 4-6 weeks. Full visual stabilization is achieved within approximately 4-6 weeks. The need for glasses is evaluated at the end of this period.
Points to Consider
It is important that chronic diseases such as diabetes and hypertension are under control before PHACO surgery. Blood-thinning medications used may need to be adjusted based on doctor's recommendations. In the presence of other eye diseases such as glaucoma, macular degeneration, uveitis, and diabetic retinopathy, post-operative expectations should be shared carefully. Not rubbing the eye, avoiding direct contact with water, and using the drops recommended by the doctor regularly during the first week after surgery directly affect success. Situations such as heavy lifting, bending over, and exposure to dust should be avoided. Swimming, saunas, and intense sports activities should be postponed for at least 2-4 weeks. In case of sudden vision deterioration, pain, redness, and flashes of light, an ophthalmologist should be consulted immediately. Lens selection should be compatible with the lifestyle, and the patient's preferences regarding glasses use should be taken into account. Factors such as computer and reading habits, and driving needs directly affect lens selection.
As Koru Hospital, we perform phacoemulsification surgeries in our ophthalmology department using state-of-the-art PHACO devices and premium intraocular lens options. Thanks to our experienced eye surgeons, personalized lens planning, and modern operating room infrastructure, we provide our patients with the highest standards of service in cataract treatment, ensuring you regain clear and high-quality vision. With our multifocal and trifocal lens options, we are by your side on the path to reducing your dependence on glasses and increasing your active quality of life. We are here with our modern equipment and experienced team to ensure our patients have a safe and successful treatment process.
