This is a routine case during which I discuss anticipation and prevention of problems caused by patient coughing, infusion misdirection syndrome, and finally the intracameral antibiotic controversy.
In this case I demonstrate techniques used to remove a dense nucleus in an eye with pseudoexfoliation. Signs of Infusion Misdirection Syndrome and methods to protect the posterior capsule when this problem exists are also presented.
Episode 29: The Use of Intraoperative Aberrometry to Confirm Toric IOL Power Calculation in a Highly Myopic Eye
After first removing the anterior subcapsular cataract in a highly myopic patient, I then demonstrate the use of intraoperative aberrometry to confirm the toric IOL power calculation. Discussions include how to best manage a significantly deep chamber and how to correct the rare occurrence of a toric IOL that rotates postoperatively.
In order to perform cataract surgery upon this non-English speaking patient, I first have to remove an iris-fixated anterior chamber lens implanted 11 years previous. This case highlights removal of the phakic IOL, the value of a translator during surgery and the use of intraoperative aberrometry to determine the correct IOL power.
This case demonstrates the use of intraoperative aberrometry plus the Aphakic Refraction Technique to best determine the final IOL power in a keratoconic eye. Tips for visualization, a comparison of phaco chop and divide and conquer and the advantages of a high IOP setting round out this very educational case.
Patience is a critically important trait for all surgeons to develop and maintain. In this patient, Dr Mackool demonstrates its value during removal of a red/brunescent cataract in a one-eyed patient.