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O P H T H A L M O L O G Y
pupil and nicking the capsule."
"For the most part, we can pick those
[conditions] out ahead of time," says Dr.
Vold, as long as the patient is subjected to a
thorough and complete pre-op exam that
includes questions about previous ocular
issues they've had and all the medications
they're taking. Then the patient must be sufficiently anesthetized. In Dr. Cunningham's
practice, about 80% to 85% of cataract
patients get topical anesthesia, while 15% to
20% get peribulbar blocks. "The risky
patients are blocked and well-sedated with
Versed and fentanyl IV," he says.
The 3 surgeons agree that having an up-todate ophthalmic microscope goes a long
way toward preventing ruptured capsules.
In particular, a scope that delivers precise
illumination through LED lights around the
lens and the red reflex feature can assist in
better visualization of finer details and
depth perception.
The latest phaco systems also offer
improved fluidics for better control and
8 6 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | A P R I L 2 013
