Simulated Surgery: Phacoemulsification: Segment Removal

The SOS Basic Gel Cataract eye does not have any cortical material but once the nucleus has been cracked into 4 quadrants trainees can practice using the second instrument to manipulate these nuclear segments towards the phaco tip and removing them without damaging the edge of the capsulorhexis.

In addition to Cybersight, you can find videos featuring teaching techniques for all types of ocular surgery, using any form of simulation, in the Simulation Gallery.


>> In this video, we’re illustrating how we use an SOS basic cataract eye to practice segment removal. And once again, just consolidating the skills that trainees would have learned with the IC modules. And these skills are really manipulation of the quadrants within the anterior chamber, making sure the phaco probe does not pass too deeply, or too close to the capsulorrhexis margins, using the second instrument efficiently, for manipulating the quadrants towards the phaco handpiece itself, and not chasing the segments of nucleus towards the edge of the rhexis. The nuclear fragments tend to be slightly lighter, less dense than live lens would be, and so they tend to float slightly more anteriorly, in the anterior chamber, than normal nuclear fragments. But the principles of manipulating the quadrants, using the second instrument, and coordinating the use of the phaco tip and the second instrument are all invaluable skills to learn, before the trainees progress towards live surgery. I tend to use slightly higher vacuums to remove the segments than you otherwise would normally do. And of course, with the basic phaco eyes, there’s no posterior capsule to be sucked up into the port. So really the only jeopardy is getting too close to the anterior capsule and causing an anterior capsular tear. In the last couple of seconds of the clip, you just see the little small remnants of the lens, which, in real live surgery, can be a little bit tricky to maneuver and to remove. And the last one, just disappearing now.

Last Updated: October 31, 2022

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