Cataract Surgery With Extreme Positive Pressure
An African American female in her 70s presented with congenital ptosis, bilateral chronic uveitis, proptosis, bilateral peripheral iridotomies, and hand-motion visual acuity in both eyes from advanced cataracts. The anterior chamber collapsed violently upon the needle’s entry, so Dr. Robert Osher injected OVD to deepen the chamber in preparation for attempting the capsulorhexis with a 22-gauge needle. The capsulorhexis was made 5.0- to 5.5-mm to ensure that the IOL’s optic would be less likely to catapult forward out of the bag in response to the positive pressure. The surgeon chose OZil Torsional ultrasound for efficiency and followability and a silicone I/A tip for added safety when dealing with extreme positive pressure.
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Comments (3)
mike an MVR blade stab at the pars plana and do a core vitrectomy for 5 seconds.
Use of ACM (anterior chamber maintainer ) is very simple and appropriate answer in this type of cases.-Dr Surinder (drsurinderkumar@gmail.com)
Dear Dr Osher I think this positive pressure would be redused if the operative table was tilted slightly to raise the pt head up to the levle of the abdomem because pt is over weight dr saeed algehedan algehedan@hotmail.com.