Doing 2-Step Cataract Surgery By Choice If Complication Arises

At times, Cataract surgery could be complicated by unforeseen problems & the surgeon panics. We propose the technique whereby the surgeon, if not able to handle the complication, postpones the surgery of his own choice after carefully closing the eye, & operates again at a second stage.

Dr T P Agrawal Eye Hospital & Institute, Meerut & New Delhi, India.

We present 20 case scenarios of Cataract surgery that had unforeseen problems, where the first surgery could not be completed. The surgeon abandoned surgery & closed the eye neatly without panicking, when he felt the case to be non-manageable. 1-2 weeks later, the surgery was completed at a second stage.

The various problems encountered included imminent posterior capsular rupture (PCR), inadvertent PCR, patient problem, surgeon problem & some unforeseen circumstances like malfunctiong of phacoemulsification unit. All surgeries could be successfully conducted at the second step. The results were comparable to a routine single step Cataract surgery.

At times there are unforeseen problems while doing a Cataract surgery. Instead of blotching the surgery, if the surgeon is unable to manage the problem at that instant, instead of panicking & doing harmful manoeuvres, he can abandon the surgery of his own choice (he should have it in the back of his mind) and plan a staged surgery. Later, once the eye is stable & one has time to plan, the surgery can be completed in a more successful way. Results in such cases are comparable to normal surgeries.