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    Retroillumination Techniques for Cataract Surgery With Vitreous Opacities

    AAO2021 Video Program
    Cataract/Anterior Segment, Complications, New Technology and Instruments

    Cataract surgery in the presence of vitreous opacities, such as in vitreous hemorrhage or endophthalmitis, is often combined with para plana vitrectomy. Even so, the cataract surgery is often very challenging due to the absence of the red reflex. In this video, we demonstrate several retroillumination techniques using a 25-gauge chandelier or a light pipe in multiple configurations to optimize visualization at various steps during these difficult cataract cases. Using either of these two light sources, we demonstrate how the light can be directed toward the vitreous to accentuate the red reflex or directed toward the posterior capsule, which crisply accentuates the lens structures. We also demonstrate that visualization can often be further improved by switching off the microscope light when utilizing these retroillumination techniques.