Eyeworld

EW CATARACT 49 October 2016 with syringe because, in my hands, direct visualization and control are better," he said. He added that when performing a tap, it is "essential to immediately, if not simultaneously, inject an OVD through the paracen- tesis to deepen the anterior chamber and to lessen the potential for a suprachoroidal hemorrhage." However, Dr. Raju said that if the need for a vitrectomy occurs in some of the earlier cases for young eye surgeons and they do not feel comfortable with this procedure, they should contact a glaucoma specialist or another senior colleague familiar with vitrectomy to step in. Dr. Zavodni said in eyes with cataract and narrow angles, he would go straight to cataract surgery, rather than a laser peripheral iridot- omy, unless the patient was describ- ing relative block symptoms and couldn't have cataract surgery in the near future, or if he didn't think they were safe to dilate for cataract surgery. In those cases, he would perform laser peripheral iridotomy first. This procedure is still his first choice for patients with narrow an- gles who do not have a cataract yet. IOL calculations IOL calculations in short eyes can be a challenge. Even a small error in predicted effective lens position could result in a large relative refrac- tive error, Dr. Zavodni said, noting that he prefers to use the Holladay 2 and Barrett Universal 2 formulas in these cases. Dr. Raju also uses the Holladay 2 formula as well as the Hoffer Q. "I have also found intraopera- tive aberrometry helpful in confirm- ing lens selection," she said. Additional advice Dr. Raju said patients with short eyes should be positioned in a way that will not add to positive pressure. That might mean the head being a little higher, with the eye above the level of the chest. To avoid suprachoroidal hem- orrhage, Dr. Zavodni cautioned surgeons to avoid large pressure fluctuation during surgery. If such a situation is suspected, the surgeon should stop the procedure, suture Contact information Raju: rajulv25@gmail.com Zavodni: zacharyzavodni@gmail.com Editors' note: Drs. Raju and Zavodni have no financial interests related to their comments. the incision, and assess the choroid using an intraoperative ophthalmo- scope. EW AAO Booth 2515 Parasol® Punctal Occluder Endo Optiks Laser Endoscopy Systems, Endoscopes and Probes Beaver-Visitec International, Inc., 411 Waverley Oaks Road, Waltham, MA 02452 www.beaver-visitec.com 411 Waverley Oaks Road, Waltham, MA 02452 Visitec® I-Ring® Pupil Expander Visitec® FLACS Cannula A Complete Portfolio of Market Leading Ophthalmic Products EXTEND® Absorbable Synthetic Implants Register for our clinical wetlabs on line at www.endooptiks.com AAO Booth 2515 BVI, BVI Logo and all other trademarks (unless noted otherwise) are property of a Beaver-Visitec International ("BVI") company © 2016 BVI Beaver-Visitec International, Inc. 411 Waverley Oaks Road, Waltham, MA 02452 Tel: 1.866.906.8080 Fax: 1.866.906.4304 www.beaver-visitec.com

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