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    AAO 2016
    Cataract/Anterior Segment, Optics & Refractive Errors

    In this presentation from AAO 2016, Robert J. Cionni, MD, presents his top-5 pearls in managing complicated cataract cases.

    • Discuss with the patient before surgery:
      • Increased risk of retinal detachment
      • Increased difficulty in hitting the refractive target
      • IOL style desired might not be available in power needed.
      • Anisometropia warnings if only 1 eye planned
      • CL removal for preop measurements
      • Near vision will require glasses if emmetropia targeted.
    • Choose the best formula for eyes with axial length of 26.00 mm or greater.
    • Expect reverse pupillary block (RPB):
      • Never begin irrigation without first separating the iris from the anterior capsule.
      • Warn the patient that they might feel exaggerated pressure changes.
      • Relieve RFP whenever performing intraoperative aberrometry and at end of case.
    • Always perform trial lenses before proceeding with enhancements of any kind.
    • Perform frequent, early postoperative exams to evaluate for anterior capsular phimosis.