Phaco emulsification in an eye with loose zonules 3+ pseudoexfoliation and ECTR implantation

[alovi]

Thanks for share your experience.

[elmotasem]

Dear Dr Gimbel:

Thanks for wonderful educating videos, one question, regarding the CAST incision, how is conjunctival ballooning during phaco, Is it happening or not?

[GimbelLibrary]

@elmotasem Thank you for your question. If you hold the conjunctiva open while placing instruments into the incision, ballooning only happens about 10% of the time. For high ballooning I use a paracentesis blade and slice the conjunctiva in the two lower quadrants to allow the ballooning to flatten. Conjunctival vessels can be avoided because of the stretch of the fluid balloon. This does not work in the upper quadrants.

[elmotasem]

@GimbelLibrary THANKS, I agree about the management, and of course I shall try this CAST incision, as of course this will causes a marked decreases in Astigmatism level since I allways work @ 12 oclock corneal incision.