Ten Pearls of Phacoemulsification with PPC
Posterior Polar Cataract is associated with remnants of Tunica vasculosa lentis. (1) It presents as a white opacity situated on the posterior capsule appearing as a circular plaque with concentric whorls. (2) Surgical management of posterior polar cataracts is a challenge even for skilled surgeons due to high risk of posterior capsular rupture and vitreous loss during surgery. (3) 1. Preoperative ...Read More
Ten Pearls for the Management of Posterior Capsular Rupture
Posterior capsular rupture (PCR) is an important complication of cataract surgery whose timely recognition and appropriate management can ensure a good visual outcome. Here are ten pearls for its prevention and management. Pearl 1: Understand the risk/predisposing factors It is imperative to assess the preoperative and intra-operative risk to prevent the development of a PCR. Elderly, anxious, and...Read More
Anterior Vitrectomy Made Easy For Cataract Surgeon
One of the most dreaded complications of cataract surgery is a posterior capsular tear (PCR). Its rate ranges from 1.3% to 9.6% (from skilled surgeons to trainees)1-5. Early recognition of the PCR and skilled management is necessary for good surgical outcomes and to avoid any devastating sequelae. Hence, anterior vitrectomy is an important skill that every cataract surgeon should master. There are...Read More
Capsulorhexis was pioneered and popularized by Howard Gimbel. Capsulorhexis is probably the most challenging to learn in cataract surgery, in other words, once a good rhexis is done half the battle is won. All the Post- Graduates and beginners struggle to do rhexis. This article has compiled small tips and tricks to do rhexis better. Ideally, rhexis should be continuous and curvilinear i.e Circula...Read More
Management of Subluxated cataract
Zonular compromise complicates every step of cataract surgery and poses a serious challenge in terms of safety and visual outcome. When the lens is displaced from its normal position, it is considered subluxated if it remains in the pupillary area and luxated or dislocated if it is completely displaced from the pupil. Ectopia lentis is the term used to describe congenital dislocations.1 Lens displ...Read More
Ten Tips for the Beginners for Performing Pediatric Cataract Surgery
Congenital cataract has a worldwide prevalence of 4.24 per 10,000 people, with the largest prevalence found in Asia (1). It is one of the most important causes of treatable causes of childhood blindness (2). 1.Timing of cataract surgery In order to prevent stimulus deprivation amblyopia, children with dense visually significant bilateral congenital cataracts, surgery should be done at around 6–8 w...Read More
Ten Pearls for Mastering Small Incision Cataract Surgery
Small incision cataract surgery (SICS) is a prevalent technique in all the high volume centres of India as it is faster, gives excellent visual outcome and is much cheaper than phacoemulsification. Tip no. 1. Do a thorough pre-operative assessment and try selecting ideal cases It is mandatory to perform a proper pre-operative assessment of the patient. Helps in preparing the surgeon to anticipate ...Read More
Ten Mistakes One Should Avoid in Small Incision Cataract Surgery
Mastering Small Incision Cataract Surgery (SICS) lays a solid foundation for achieving sutureless cataract surgery in the majority of the cases. This article aims to bring forth some commonly committed errors in SICS. Nuclear grade: Though a surgeon is not expected to choose a patient, but a beginner should avoid extremes of nuclear grade. A grade 3 nucleus with a 6mm external incision and >6mm ca...Read More
1. Science behind Multifocal Intraocular Lens (MFIOL) Multifocal intraocular lenses are IOLs which can separate incoming light into two or more foci, thus resulting in multiple coexisting retinal images. At any given point, only one of the images (distance, intermediate or near) is the sharpest, and hence selected by the brain for visualisation. This concept is known as simultaneous vision. The vi...Read More
Ten Pearls for Phacoemulsification in a Soft Cataract
Soft cataracts are usually seen in pediatric or young adult patients. We encounter them more frequently nowadays due to the increasing patient awareness and evolving lifestyle requirements which bring the patients earlier to the clinic. Another important reason behind the increasing number of soft cataracts in our surgical practice is the fact that the number of pars plana vitrectomies is increasi...Read More