Practical tips for young ophthalmologists

When performing cataract surgery “capsulorhexis should be continuous, curvilinear and it should overlap the optic 360 degrees,” said Nic Reus MD, Netherlands, addressing the Young Ophthalmologists Starting Phaco session at the 38th Congress of the ESCRS. The session was chaired by Dr Oliver Findl, Chairperson of the ESCRS Young Ophthalmologists Committee. To ensure a continuous curvilinear capsulorhexis he said the surgeon should make a mental note of the size of the circle they want to make, and follow that imaginary line. During his practical presentation, Dr Reus demonstrated the three different incisions that can be used; single plane corneal incision, biplanar, and three-step scleral incision. When entering the anterior chamber, the most stable incisions are square (not too short and not too long), he said. Regarding hydrodissection, Dr Reus advised looking out for both the anterior wave and the posterior wave. Giving an expert overview of phacoemulsification during this session, Filomena Ribeiro MD, Portugal, said there are three key points: good visualisation, a stable anterior chamber, and being efficient. She stressed the importance of protecting the endothelium and posterior capsule and not putting stress on the zonules. Discussing cracking techniques, Dr Ribeiro said the best technique depended on the individual case and surgeon, but the ‘divide and conquer’ approach is versatile and best for beginners. “Chop techniques provide significant advantages in terms of reduction of phaco power and time and result in less strain on the zonula.”

Tags: cataract surgery capsulorhexis, ESCRS Virtual Congress 2020