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    Pearls for managing tricky cataracts in post-vitrectomy eyes

    One surgeon offers several pointers in managing such cases, thus avoiding surprises

    Boston–Cataract surgery in the post-vitrectomized eye is considerably tricky but with some surgical experience and implementing some valuable pearls—including whether to hydrodissect or hydrodelineate—surgeons can avoid surprises, according to Bonnie An Henderson, MD.

    More Cataract: Correcting complications in premium cataract surgery

    “First, ensure you are not hydro-dissecting these eyes, but hydro-delineating,” said Dr. Henderson, partner at Ophthalmic Consultants of Boston and clinical professor at Tufts University, Boston. “The telltale sign of a successful hydrodelineation is the ‘golden ring.’ Be aware these lenses are unlikely to rotate well, so carefully proceed with chopping and removing the fragments to debulk the nucleus.”

    More Cataract: Learn how image-guided system streamlines cataract surgery planning

    Dr. Henderson presented this case during a panel discussion on cataract complications at the 2015 meeting of the American Academy of Ophthalmology.

    When performing such surgeries, Dr. Henderson prefers to move her phaco tip “to get to the different areas of the bisected nucleus and then try to segment them into smaller pie pieces,” rather than attempting to rotate the entire lens and keeping the phaco tip in the center.

    Patience is required

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