Aim A well docked stable patient interface (PI) with minimal patient discomfort. The new SoftFit PI makes this step intuitive and simple. Principles Measure the patient’s pupil dilation before wheeling them to the femtosecond laser as it interrupts patient flow if you have to wheel them out again while they continue to dilate. Use a […]
Aim A patent side port. Principles Stabilize the eye with a Thornton ring or alternative. You will know from your programmed parameters how many degrees your side ports will be from your main incision. They can sometimes be difficult to find. If so, dry the cornea and they may be easier to see. The incision […]
Opening Main Incision
By: Dr Lewis Levitz Posted in: Main Incision, Procedure
Aim A clean open self-sealing incision. The SoftFit makes superb wounds which are usually easy to open, especially if the PI was well docked. Principles Stabilize the eye with a Thornton ring or similar. You can often identify the main incision site by looking for a line of gas bubbles in the stroma. Insert the […]
Removing the Capsulorhexis
By: Dr Lewis Levitz Posted in: Capsulorrhexis, Procedure
Aim A free circular capsulorhexis . Principles Inspect the capsulorhexis and look for the appearance of a “clear red gutter” around the central capsular button to see if it looks free. It almost always is free and may even be floating in the anterior chamber. Use a capsulorhexis forceps to grab the central circular flap and […]
Aim In the rare event of a micro-adhesion you must complete the circular capsulorrhexis without having the anterior capsule tear. Principles Very very occasionally there will be capsular micro-adhesions where the capsule has not been cut completely free. There are various types of tags. One or two small micro-adhesions in an otherwise free flap A […]
Hydrodissection
By: Dr Lewis Levitz Posted in: Hydrodissection, Procedure
Aim A freely mobile nucleus. Decompressed posterior capsular compartment which may be pressurized due to retro-lenticular and intra-lenticular gas. Principles “Burp” the incision site slightly to let out some of the viscoelastic. Do this with gentle pressure on the posterior lip of the incision with the capsulorhexis forceps once the capsule has been removed from […]
Nucleus Removal
By: Dr Lewis Levitz Posted in: Nucleus Removal, Procedure
Aim A freely mobile nucleus. Decompressed posterior capsular compartment which may be pressurized due to retro-lenticular and intra-lenticular gas. Principles “Burp” the incision site slightly to let out some of the viscoelastic. Do this with gentle pressure on the posterior lip of the incision with the capsulorhexis forceps once the capsule has been removed from […]
Cortex Removal
By: Dr Lewis Levitz Posted in: Cortex Removal, Procedure
Aim Remove the cortex safely taking into account that this process is different from the usual cortical clean-up. Principles The cortex will have been cut flush with the capsule thereby eliminating the cortical strands that are usually easily aspirated in manual cataract surgery. The cortex may be removed either using a bimanual or co-axial irrigation […]
Complications
By: Dr Lewis Levitz Posted in: Complications, Procedure
Incision site does not line up with capsulorrhexis If the eye was tilted when docked, the capsulorhexis may be para-central but the main incision and secondary port do not line up radially with the center of the capsulorrhexis. The resulting problems: • The incision in the cornea is started obliquely and may not enter the […]