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Thumbs Up on Safety Scalpels - Outpatient Surgery Magazine - May 2019

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 9 C ataract sur- geons who claim they're not worried about piercing the posteri- or capsule with a sharp instrument or oscillating phaco tip? "They're either lying or retired," says Uday Devgan, MD, a cataract sur- geon in Los Angeles, Calif. While posterior capsular ruptures are rare — it's estimated they occur in 6% of novice sur- geons' cases and in less than 1% of experienced physicians' proce- dures — they increase the risks of endophthalmitis and cystoid macu- lar edema, adverse events that adversely affect patients' post-op vision. But a rupture impacts more than quality outcomes. Your case costs and profit margins suffer collateral damage. Consider: • Surgeons must open 2 or 3 more tubes of viscoelastic to keep the tear from expanding, and prevent or limit vitreous loss. • They must use intracameral preservative-free triamcinolone dur- ing clean-up of the tear to increase visualization of the vitreous that prolapses into the anterior chamber. • They must open an anterior vitrectomy pack, use acetylcholine chloride intraocular solution to constrict the pupil, and administer Daniel Cook | Executive Editor • ALWAYS AWARE Jeffrey Whitman, MD, who has performed thousands of cataract surgeries, knows a cap- sular tear could occur during his next case. Jeffrey Whitman, MD Pointers to Prevent Posterior Capsular Rupture Devices and drugs to avoid the complication every cataract surgeon dreads — when the capsular bag unexpectedly breaks during the case.

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