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Pearls can ‘make the difference’ in cataract surgery
KOLOA, Hawaii – Six pearls of technique for cataract surgery can “make the difference between an effortless case or a demanding one,” according to William J. Fishkind, MD.
Dr. Fishkind’s first pearl is that the surgeon should make sure to check the patient’s head position before leaving the preoperative area. “If the chin is too high or too low, the case will be much more difficult,” Dr. Fishkind said here at Hawaii 2004: the Royal Hawaiian Eye Meeting.
The second pearl is to use a clear corneal temporal incision location.
Third, before capsulorrhexis, the surgeon should loosen the speculum and use adequate viscoelastic.
“The vector forces tend to push the lens forward, causing the capsulorrhexis to tear, which is a common problem. Viscoelastic can push the lens back, which is really helpful and makes a difference,” Dr. Fishkind said.
The fourth pearl, he said, is to use the new phacoemulsification technologies. With the new technologies, “every pulse creates energy to break the nucleus and keep it even. The new machines can be programmed to respond like peristaltic or venturi pumps,” he said.
Switching from cracking to phaco chop is pearl No. 5, he said: “It’s faster, it’s safer, it’s easier, and it’s better.”
Dr. Fishkind’s final pearl is to evaluate one’s surgical performance routinely. “Perform outcomes analyses, and videotape your procedures,” he advised.