Phacoemulsification, PC-IOL Implantation, and Posterior Lamellar Corneal Transplant in Eye With Hard Cataract and Severe Bullous Keratopathy

Eyetube

This video presents a combined procedure for the surgical treatment of a mature, hard nucleus cataract and severe bullous keratopathy. Ozana Moraru, MD, highlights the difficulties of working in poor visibility conditions and the chop technique for a brown cataract, followed by the hydro-implantation of a posterior chamber IOL and the insertion of the DSAEK lamella.

Surgical Options for Patients With Cataracts and Open-Angle Glaucoma

Recent studies evaluated the efficacy of MIGS combined with phacoemulsification.

Maxwell de la Paz, BS, and Linda M. Tsai, MD

Cataract and Refractive Surgery Today

Key Takeaways Recent studies have evaluated the efficacy of MIGS combined with phacoemulsification in eyes with open-angle glaucoma. Trabecular procedures combined with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. Compared to phacoemulsification alone, combining the procedure with MIGS appeared to provide a greater reduction in IOP and the number of medications required postoperatively without decreasing safety. Trabecular Procedures Combined with Cataract Surgery for Open- Angle Glaucoma: A Report by the American Academy of Ophthalmology Richter GM, Takusagawa HL, Sit AJ, et al1Industry support for this study: None ABSTRACT SUMMARY This report compared the IOP reduction of various trabecular procedures combined with cataract surgery to that of cataract surgery alone in patients with hypertensive open-angle glaucoma (OAG). Patient-specific considerations that might guide procedure selection were also investigated. STUDY IN BRIEF A report drawing on 10 randomized controlled trials found that combining trabecular procedures with cataract surgery provided a greater IOP reduction than cataract surgery alone in patients with hypertensive open-angle glaucoma. The trabecular procedures themselves showed no clear benefits over one another for IOP or medication reduction, but direct comparison studies are required. The risks of uveitis and bleeding were among the factors that might influence surgeons’ choice of trabecular procedure. WHY IT MATTERS In patients with well-controlled hypertensive open-angle glaucoma, cataract surgery may reduce their medication burden by 0.8 to 1 at 2 years. When cataract surgery is combined with a trabecular procedure, a further 0.4-reduction may occur.1,2 Because the combined trabecular procedures in this AAO report offered similar benefits, patient factors and surgeon preference may be more important when offering specific options.

Management of Retained Subretinal Perfluorocarbon Liquid

Antonio Acquaviva, MD

Eyetube

This patient had retained subfoveal droplets after PFCL was used during retinal detachment repair. An ILM peel was performed, followed by a retinotomy adjacent to the inferotemporal vascular arcade using a 41-gauge extendible subretinal injection needle. Through the same retinotomy, the bent 41-gauge needle was advanced into the subretinal space to reach the PFCL bubble. Subsequently, active aspiration of PFCL was performed, followed by short-term postoperative upright head positioning. By the OCT scan, this technique appears to be an effective surgical approach for removing a retained submacular PFCL bubble.