Dr.Chekitaan Singh, Dr.Reena Gupta, Dr.Ishwar Singh, Dr.Dhull Chand Singh
Phacoemulsification (phaco) in vascularised corneal opacities is a challenge even for the most seasoned surgeons. We describe a case of successful phaco with IOL implantation in a vascularised macular corneal opacity in a one eyed patient. We begin with peribulbar anaesthesia and creating a conjunctival flap in case a conversion to ECCE or SICS is required intra-op. Trypan blue staining for capsulorrhexis and a technique for modifying the light falling on the cornea from the microscope using the surgeons finger is described. We also depict how an endo-illuminator(light pipe) can be used hand in hand with dimming the microscope light for significantly enhancing visibility and contrast for achieving easy chopping of nuclear fragments, irrigation, aspiration of cortical matter. Light pipe also greatly aides visualization for assuring complete cortical matter removal and implantation of IOL in the bag. Our video illustrates these steps and tricks in detail to achieve surgical success.