NOV 06, 2017
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.