27/01/2019
“We cannot always bring our A game every time we operate, but we can grind out a win for the patient nonetheless.”
20/20
-0.25D
Day 1
In the end, those are the only data that really matter to the patient.
But now it can be told...
We were assigned a tough solid intumescent cataract for the live phacoemulsification cataract surgery.
Vision was hand motions only. Intraoperatively, there was a runaway peripherally extended capsulorrhexis. That could have led to a cascade of events that would have made a disastrous surgery.
We had to complete the capsulorrhexis through the opposite side. Slow motion phaco was done. We attacked the area of the extension first and cleared that quadrant to lessen the stress in that portion of the bag. Slow and deliberate movements were used in nuclear disassembly and phacoemulsification.
It was a tough solid cataract that did not have cortical material. There was no protection from the posterior capsule which would occasionally rise with positive pressure coming from the vitreous. This would present a great danger as the cataract material remaining lessened.
We elected to implant the IOL earlier so as to provide a safe barrier between the posterior capsule and the remaining pieces. The last pieces were patiently aspirated. The IOL was centered and the surgery concluded.
A clear cornea and perfect 20/20 vision greeted us on the first post-op day. The pristine round pupil, intact iris, and achievement of the target refraction were all icing on the cake.
To perform all of this live and make the correct decisions and proper maneuvers with over a hundred people watching is indeed a great honor.
In our practice, we always look for opportunities to take on difficult cases. We have always believed in the power of character-building ORs. We cannot always bring our A game every time we operate, but we can grind out a win for the patient nonetheless.
Again, the only important data:
20/20
-0.25D
Day 1
