JUL 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

Issue link: https://digital.eyeworld.org/i/146899

Contents of this Issue


Page 39 of 66

July 2013 Cataract challenges make an error. "The bag can be so floppy, it can come up to your phaco tip," she said. Pulling out one more time, even for a remaining small piece, and filling up the bag again can help avoid this, she said. Use of a dispersive viscoelastic in patients with dense cataracts helps to protect the corneal endothelium, Dr. Bordewick said. "I don't hesitate to use dispersive viscoelastic above and below the fragments I'm removing. Sometimes the posterior plate is difficult to split. If you take viscoelastic with a cannula and a protective sleeve, you can inject visco under that plate and move it forward away from the posterior capsule. Then it's safer to remove it," she said. You should also consider using a CTR if necessary to make sure the lens is well centered, said Dr. Kim. Burned by phaco burns? The surgeons interviewed have not experienced phaco burn that often, although it's always a risk, said Dr. Bordewick. "It's obviously a concern because you're typically using higher settings and more phaco energy. I use phaco in short bursts and add some chopping to that to minimize the amount of heat," she said. Dr. Pettey had a phaco wound burn referred to him not long ago, and he followed the advice of Majid Moshirfar, MD, professor of ophthalmology, University of Utah, Department of Ophthalmology and Visual Sciences, and in practice, John A. Moran Eye Center, Salt Lake City. "When the wound edges are fish-mouthed, you need something to fill the void created by wound edge contracture. My last case had a large wound gape, and rather than suture down the edges tight with resultant 10 or fewer diopters of cylinder, I suspended the amniotic membrane in the wound to act as a filler and reduce the tension required for suturing," said Dr. Pettey. The patient was happy with the outcome and had a surprisingly good uncorrected visual acuity. EW Editors' note: The physicians have no financial interests related to this article. Contact information Bordewick: eyestuff3@new.rr.com, dbordewick@baycare.net Kim: 408-851-4012, evasterbunny@gmail.com Pettey: 801-581-2352, jeff.pettey@hsc.utah.edu PLAN AHEAD FOR NEXT YEAR YEAR HOUSI NG IS NOW OPE N HOUSING NOW OPEN www.WinterUpdate.org www.WinterUpdate.org 2014 2014 APRIL 25–29 APRIL 25–29 BOSTON www.ASCRS.org www.AS C R S.org

Articles in this issue

Links on this page

Archives of this issue

view archives of Eyeworld - JUL 2013