Early uncorrected visual acuity as a measurement of the visual outcomes of contemporary cataract surgery.

Purpose: To determine the uncorrected visual acuity (UCVA) on the first postoperative day and the fifth week after routine slow-motion phacoemulsification with posterior chamber intraocular lens (IOL) implantation.

Setting: Cincinnati Eye Institute, Cincinnati, Ohio, USA.

Methods: This retrospective chart review performed by 3 research fellows analyzed the UCVA 1 day and 5 weeks postoperatively in 100 consecutive best-case scenario eyes of 99 patients who had routine slow-motion phacoemulsification with implantation of an AcrySof single-piece IOL (Alcon).

Posterior capsule tear caused by misalignment within a silicone irrigation/aspiration tip.

We describe a surgical complication with the Alcon silicone irrigation/aspiration (I/A) tip. In 2 consecutive cases, the posterior capsule was torn because of a misalignment between the inner metallic shaft and the hole in the silicone I/A tip. To achieve the protective benefits of this device, the surgeon must visually confirm proper alignment of the outer silicone and inner metallic portion of the tip.

Management of lens-iris diaphragm retropulsion syndrome during phacoemulsification.

Lens-iris diaphragm retropulsion syndrome (LIDRS) occurs more often than recognized during small-incision phacoemulsification. This syndrome requires an infusion of fluid into the anterior chamber and is characterized by posterior displacement of the lens-iris diaphragm, marked deepening of the anterior chamber, posterior iris bowing, pupil dilation, and often significant patient discomfort. Using microendoscopy, we have observed that LIDRS is essentially a reverse pupillary block.

Cataract surgery without preoperative eyedrops.

We present a technique that uses intracameral lidocaine to induce pupil dilation without using preoperative mydriatic eyedrops. After 1 or 2 drops of topical lidocaine hydrochloride 1% (Xylocaine-MPF 1%) are applied to the ocular surface, a 1.0 mm side-port incision is created through which Xylocaine-MPF 1% is injected into the anterior chamber.