FEB 27, 2023
Crouching Tiger, Hidden Fragment: Techniques to Discover and Expel Cataract Fragments that Hide in the Anterior Chamber Angle and Sulcus During Phacoemulsification
AAO 2022 Video Program
Cataract/Anterior Segment, Complications
How much "rebound inflammation" is really caused by retained fragments hidden in the angle or sulcus is unknown. This work suggests retained fragments may be more common than we realize, but it also shows novel techniques to remove and prevent them. To expel sulcus fragments, cannula rinsing failed in 9 of 10 cases, but retropulsing the intraocular lens (IOL) with irrigation/aspiration (I/A) on high flow succeeded in 9 of 10 cases. To expel angle fragments, angle rinsing worked for most and I/A suction removed the rest. At the end of routine cataract cases, rinsing the angle with a cannula and gently retropulsing the IOL with the I/A handpiece on high flow is encouraged to help discover and expel hidden angle and sulcus fragments.
Financial Disclosure: Dr. Lawrence Tenkman discloses no financial relationships.