Key advice for cataract surgery with opaque corneas

[caption id="attachment_16662" align="alignleft" width="1024"] Bjorn Bachmann[/caption] Performing cataract surgery in the presence of an opaque cornea can be successfully achieved with a combination of rigorous surgical techniques and by respecting certain guidelines, according to Bjorn Bachmann MD. Speaking at the joint ESCRS/EuCornea Symposium at the 37th Congress of the ESCRS, Dr Bachmann said that key steps in a successful procedure included localisation of the key incision site, good control of the red reflex, optimal illumination using a variety of external, intracameral or intravitreal approaches and the application of appropriate staining to enhance visualisation. “The main incision should be placed opposite the clean work zone, and we can try to improve the red reflex by using coaxial instead of full field illumination and by enlarging the pupil. It is also advisable to avoid contact of dye with diseased endothelium when staining the anterior capsule,” he said. Dr Bachmann noted that there are certain situations where it is advisable to perform cataract surgery before or without corneal surgery. “This would include cases of mild or peripheral corneal opacification or in patients where there is a high risk of corneal graft failure after penetrating keratoplasty. It should also be avoided in those with a history of good visual acuity before cataract formation, and eyes with low expectations in visual acuity such as amblyopia or post-retinal detachment,” he said.