tion of the fragmented lens.
Retentive viscoelastic solutions can help
maintain space in the anterior chamber, so
surgeons can more easily maneuver instru-
ments. You can also place visco behind a loos-
ened lens nucleus to maintain a safe barrier
between it and the wall of the anterior cham-
ber. "If a posterior capsular tear does occur,
placing viscoelastic over the tear before you
remove the phaco tip or I/A handpiece from
the eye prevents [the tear] from becoming
larger and limits vitreous loss," says Dr.
Whitman.
2. Cutting cataracts
Dr. Whitman is more aware of the risk of a
posterior capsular tear occurring when he
operates on patients with floppy iris syn-
drome, previous eye trauma or phacodonesis,
which is seen in patients with pseudoexfolia-
tion and weakens the zonular fibers that sta-
bilize the posterior capsule.
He says using a femtosecond laser to frag-
ment dense cataracts lowers the risk of cap-
sular rupture during cataract extraction by
limiting the stretching of zonular fibers
attached to the capsular bag and lessening
the amount of force applied to the bag. It
also means you can remove lens fragments
with minimal phaco energy (tears are more
9 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 9
9 Orchard, Suite 111
Lake Forest, CA 92630
www.optisurgical.com
info@optisurgical.com
Call AOI for Information
800.576.1266 or
949.580.1266
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