SPRING 2025 | EYEWORLD | 59
C
the vitreous. "Part of the reason pseudophakic
bullous keratopathy has become less common
is that our phaco machines and surgical tech-
niques have become more efficient, making our
surgeries shorter and requiring less energy. One
important advancement in our phaco machines
is the ability to adjust the intraocular pressure
at which we operate," Dr. Goyal said. "Normally,
I'm operating at physiologic eye pressure, but
if I need to deepen the chamber, I can raise the
IOP. There is potential to disturb the dispersive
viscoelastic in the eye when operating at a
higher IOP, however, as long as the irrigation
ports are pointing sideways and the wound
is sealed around the phaco sleeve, disturbance
of the dispersive viscoelastic above you should
be minimal."
continued on page 60
Figure 1. Patient referred for persistent corneal edema after
uncomplicated cataract surgery; initial visit, 3 weeks postop,
CF vision, superior well-demarcated corneal edema
Figure 3. Air bubble placed with 30-gauge needle at the slit lamp
Figure 2. Slit beam exam reveals detached Descemet's membrane
Figure 4. Complete resolution of Descemet's membrane detachment
1 week later, and vision improved to 20/30
Source (all): Himani Goyal, MD
