High Efficiency Cataract Surgery by Dr. Shawn Cohen, McGill University, Montreal

Clear Cornea cataract surgery 4.5 minute video, unedited, with Acrysof IQ lens insertion. This video demonstrates Dr. Shawn Cohen's high efficiency cataract surgery technique with his development of the 3-way initial cracking of the nucleus and "sideways phaco" technique, as well as the "momentum" cortex removal technique. These techniques are especially useful for weak zonules, as in pseudoexfoliation and trauma.

Category:

Science & Technology

Tags:

• cataract
• surgery
• video
• phaco
• procedure
• phacoemulsification
• clear
• cornea
• shawn
• cohen
• mcgill
• montreal
• efficiency
• efficient
• 2009
• 2010
• 2011
• modern
• technique

[DrShawnCohen]

Thank you for your comments. I wish you a quick and speedy recovery and great success! Surgery is only done once but if a "film" or "membrane" develops over the back of the lens that we insert, a painless laser is used to remove it. The film develops in 10-20% of completely routine cases, randomly, and really needs only be cleaned once in a lifetime. "Coke bottle" glasses resulted from not having the lenses we have today!

[eyemd76]

Hi Shawn,

Great video. Very efficient. I like how you did I/A. You didn't peel the cortical material from the capsule; it kind of just all came to the tip. What settings do you use?

[DrShawnCohen]

Thanks! The vacuum is linear (usually 550) and that's what allows it to come. When the cortex starts to move or flap around from gentle foot pressure on the vacuum pedal, kinetic energy is imparted to it. Given that bodies in motion tend to stay in motion and bodies at rest stay at rest, flooring the pedal allows the cortex to come before the capsule has a chance to react. Also, with the mouthpiece full, capsule isn't able to approach. Just physics!

[DrShawnCohen]

Aha! Great idea although I now see that what I should have explained in the video was that I am also trying to cut costs and use less equipment. I use a 0.55 cc Provisc for the entire operation for a few dollars and so the cost to the patient for the lens insertion portion is zero. At 30 cases per half day, that gets expensive otherwise.

[DrShawnCohen]

It isn't supposed to. Please see my response from 4 months ago in response to the question by Phoneeei. My motto is "pain is forbidden", though the patient can still feel touch, and sometimes pressure. Pain is very rare and when it begins, I stop the operation and give more anesthetic and that solves it. After surgery, it is normal to feel like there is gritty feeling or sand-like sensation in the eye but that usually passes overnight.

[robsterrex]

do we all have to take this surgery ?????

[DrShawnCohen]

No. Cataract surgery is mainly for those whose vision has dropped and would like to regain it. People with cataracts find the world less bright, may have trouble reading even with glasses, may have trouble with night vision, may suffer from glare in bright lights, and may have trouble driving. Without constraining symptoms, there is no usually need for surgery.

[rnheacox]

Hi, saw the video, amazing. Having my left eye done as I'm finding it hard to see road signs until right up to them. Surgery is scary though. Question? Has or can it be done more than once? I so wished my mother when she was alive could have had it done again, she had both eyes done at the same tme (mistake) she ended up having to wear "coke bottle " glass's. Of course that was 20 or so years ago. I do hope my surgery is a success. Thanks for the video.

Nanc

[bolbystewart]

I liked the video. It was good quality and you are a very efficient and slick surgeon. I have been trying a few extra steps in being more efficient. One is to stop using viscoelastic to inflate the bag for IOL insertion. I started using the irrigating canula from a bimanual I & A set, and shooting the IOL with the acrysert (ALCON) or by using a Staar Collamer. ( Need a plunger system ). Then hydrate the CCI and you are done. I am able to leave out the visco removal step= more efficient

[owenwarunek]

does it hurt??