Cataract Phacoemulsification and Intraocular Lens Implantation in a Small Pupil Case

Intro
Phacoemulsification and intraocular lens implantation is the gold standard procedure for removing cataracts in developed countries. The patient is an elderly adult who underwent the surgery to alleviate visual impairment from a significant age-related mixed cataract. Before the surgery, his visual acuity in the operative eye was 20/60.

Methods
This video highlights the steps of cataract phacoemulsification and intraocular lens implantation in a small pupil case, including paracentesis, epinephrine-lidocaine (epi-Shugarcaine) injection for extra dilation and anesthesia, viscoelastic injection into the anterior chamber, capsulorrhexis, hydrodissection, phacoemulsification featuring a divide and conquer technique, cortical irrigation and aspiration, intraocular lens insertion, and wound sealing by hydration.

Results
No complications arose during the procedure. At the two-week postoperative follow-up, the patient’s visual acuity in the operative eye was 20/30. He denied any pain or discomfort. The visual acuity at four weeks was 20/20. The patient was pleased with results of the surgery.

Conclusion
Phacoemulsification and intraocular lens implantation is a safe and effective surgery for the management of cataracts. In the setting of a small pupil, intracameral epinephrine-lidocaine mix (epi-Shugarcaine) can be administered for extra dilation.

Authors
Michelle L. Huynh, BA
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Joseph G. Chacko, MD
Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Surgeon
Joseph G. Chacko, MD
Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Music
Royalty Free Music from Bensound

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