Top Story

PUBLICATION EXCLUSIVE: Three rules for corneal phaco incisions

August 23, 2017

Over the last two decades, cataract surgery has evolved from scleral incisions to corneal incisions, from retrobulbar anesthesia to topical anesthesia, and from rigid IOLs to injectable IOLs. Currently, most surgeons use a corneal incision during cataract surgery because it allows less anesthesia, faster recovery, enhanced access to the anterior chamber and excellent visual outcomes. Residents now start learning cataract surgery with corneal incisions and then learn scleral tunnels later in their training. But be warned that a poorly constructed corneal incision can start a cascade of problems during cataract surgery and could put the patient at a higher risk for complications. I have developed three rules of corneal incisions to help young surgeons learn this critical step of cataract surgery.

The best corneal phaco incisions are the ones that barely nick the limbal blood vessels. This is because they are peripheral, far from the visual axis, and produce less astigmatic effect. In addition, the vascular nature allows for more secure and better long-term sealing. A completely avascular corneal incision only heals to a small fraction of its original strength and can be opened even years later with relatively blunt instruments. A corneal incision that nicks the limbal blood vessels will seal securely and return to a high level of strength. This type of incision cannot easily be reopened and will have to be recut in the rare chance that another procedure is warranted in the future.

In the Journals

Childhood BMI linked to early ischemic stroke

August 23, 2017
Increases in BMI during childhood and above-average BMI in childhood was associated with the age a person had an ischemic stroke, according to findings recently…
In the Journals

Intensive BP control confers better patient outcomes, more cost-effective

August 23, 2017
When compared with standard BP control, intensive control of systolic BP prevented CVD events, extended life and did so at a lower cost than common willingness-to-pay…
In the Journals

Intensive, standard BP treatments confer similar quality of life, mental outcomes

August 23, 2017
Patients with hypertension who received intensive treatment had comparable quality of life, mental and satisfaction outcomes compared with patients receiving standard…
In the Journals

Rotavirus vaccination saves over $1 billion in US health care costs

August 23, 2017
The introduction of rotavirus vaccines in the United States reduced the number of acute gastroenteritis-related hospitalizations from 2008 to 2013 by 382,000, saving
More Headlines »
CE CME CNE

Domestic Violence 3 Hour: Focus on Child Abuse

This activity is not supported by a commercial educational grant.

This course focuses on child maltreatment, abuse and neglect within the larger context of domestic or family violence…
More »
Feature Article

Determining When It Is Safe to Remove the External Fixator: Results From a Survey of the Limb Lengthening and Reconstruction Society

Orthopedics
Online Advanced Release, August 18, 2017
Thousands of external fixators are applied for distraction osteogenesis each year. Determining when it is safe to…
More »
Resource Centers
Rheumatology Nurses Society Annual Conference

Rheumatology Nurses Society Annual Conference

Video
Meeting News

VIDEO: Meniscal repair is a viable option for revision ACL reconstruction

August 18, 2017
More »
Advertisement
Advertisement