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ACQUIRED CATARACT

• Morphological1. Classification of age-related cataract

• According to maturit

• Dia!etes

• Motonic dstroph

• Atopic dermatitis

• Trauma

". #ther causes of cataracts

$. %urger

•  %econdar &complicated'

• (arge incision e)tracapsular e)traction

• *hacoemulsification

•  Drugs

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Classification of Age-related Cataract According to Morpholog

1. %u!capsular•  Anterior

•  *osterior

". +uclear

$. Cortical

,. Christmas tree

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%u!capsular cataract

Anterior *osterior

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+uclear cataract

•

  E)aggeration of normal nuclear  ageing change

•  Causes increasing mopia

•

  Increasing nuclear opacification

•  Initiall ello then !ron

*rogression

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Cortical cataract

  Initiall acuoles and clefts *rogressie radial spo/e-li/e opacities

*rogression

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Christmas tree cataract

  *olchromatic0 needle-li/e opacities Ma co-e)ist ith other opacities

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Classification according to maturit

Immature Mature

permature Morgagnian

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#ther causes of cataract - dia!etes

2uenile

•  3hite punctate or snofla/e  posterior or anterior opacities

•  Ma mature ithin fe das

Adult

• Cortical and su!capsular  opacities•  Ma progress more 4uic/l than  in non-dia!etics

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#ther causes of cataract - motonic dstroph

•  Motonic facies

•  5rontal !alding•  678 of patients after age "7 ears

•  %tellate posterior su!capsular opacit

•  +o isual pro!lem until age ,7 ears

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#ther causes of cataract - atopic dermatitis

•  Cataract deelops in 178

of cases !eteen 19-$7 ears

 •  :ilateral in ;78

•  5re4uentl !ecomes mature

•  Anterior su!capsular pla4ue

  &shield cataract'•  3rin/les in anterior capsule

C f t ti t t

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Causes of traumatic cataract

*enetration

Concussion

ring from  imprinting of iris pigment   5loer-shaped

•  Ioni?ing radiation

•

  Electric shoc/ 

•  (ightning

#ther causes

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DrugsChlorproma?ine

•  (ong-acting miotics#ther drugs

• Amiodarone• :usulphan

- initiall posterior su!capsular

%stemic or topical steroids

- central0 anterior capsular granules

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%econdar &complicated' cataract

•

  Chronic anterior ueitis•  igh mopia

*osterior su!capsular

•  ereditar fundus dstrophies•  Central0 anterior su!capsular  opacities

@lau/omflec/en

•

  5ollos acute angle-closureglaucoma

E l i

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E)tracapsular cataract e)traction

1. Anteriorcapsulotom

". Completion of   incision

$. E)pression ofnucleus

,. Cortical cleanup

. *olishing of posterio  capsule0 if appropria

9. Care not to aspirateposterior capsule

  accidentall

E t l t t t ti & t '

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B. @rasping of I#( an  coating ith iscoel

  su!stance

E)tracapsular cataract e)traction & cont. '

;. Inection of   iscoelastic

  su!stance

6. Insertion of inferior

  haptic and optic

11. *lacement of haptics  into capsular !ag

17. Insertion of superi

  haptic

1". Dialling of I#( inthori?ontal position

  and not into ciliar  sulcus

*h l ifi ti

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*hacoemulsification

1. Capsulorrhe)is ". drodissection

$. %culpting of nucleus ,. Crac/ing of nucleu

9. Emulsification ofeach 4uadrant

. Cortical cleanup a  insertion of I#(