Dense Cataract

WASHINGTON — Dense lenses can cause problems during cataract surgery but do not have to be a cause for panic, according to a presenter at Glaucoma Day at the American Society of Cataract and Refractive Surgery meeting.

Horizontal chopping is my preferred phaco technique because it works well for any density of nucleus, independent of pupil size.

Training ophthalmology residents on complicated cataract cases can be, well, complicated. They need to be able to practice surgical maneuvers in a low-stress environment, allowing time for repetition and mastery of technique, so that their execution in the OR will be flawless. Encountering a complication that leads to an adverse outcome can be a devastating experience for a surgeon in the making, and the resulting hit to his or her confidence is a significant setback. Often these residents will become more timid and indecisive, which leads to an increased likelihood of more trouble.