About Video

This video describes during phaco procedure, the surgeon will always have the risk of PCR in mind. He or she will, therefore, try to observe the posterior capsule whenever possible. Specially during phaco surgery, a PCR can also lead to a dropped nucleus or dropped nucleus fragments. In case the surgeon realizes a tear in the posterior capsule, the best is to stop and remove the phaco tip from the eye, assess the situation and accordingly complete the surgery. This may mean enlarging the incision, removal of nucleus fragments with the fish-hook, cortex cleaning and anterior vitrectomy. Depending on the situation, the desired IOL could still be placed in the bag, or a larger PMMA IOL in the sulcus in front of the anterior capsule with an intact CCC. At the end of this instruction course, this video summarize all the important steps of phaco surgery and conclude with the following suggestions: phaco should not replace SICS. Continue with SICS on elderly patients with hard nuclei and use phaco only on suitable patients. Use phaco also on patients who cannot afford a foldable IOL and insert a PMMA lens, which will provide the same visual outcome. This applies also to ophthalmologists undergoing phaco training. According to a special format, each surgery and its outcome should be recorded and the summary of every 50 surgeries be discussed with the surgical trainer. For all surgeries, also for phaco, there will be a learning curve. With a stepwise training under the supervision of an experienced phaco surgeon, it should be possible to keep the complication rate below 5%. Poor visual outcome of less than 6/60 on the first post-operative day should not exceed 5%. To become a confident phaco surgeon with rare surgical complications and consistent good results, you may need to perform several hundreds of phaco surgeries, in our experience 400 to 500. Once you master this technique, you will be able to provide excellent vision to cataract patients and help to prevent and cure visual impairment and blindness for many patients.