Please answer honestly

[golgi]

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How many times have you or someone you know dropped a nucleus in residency (i.e retained fragments needing PPV)? Would appreciate honest answers...

 

[Eyefixer]

I had 2-3 cases where I dropped some cortex which was observed afterwards and did not necessitate PPV. I had 1 dropped nucleus when I operated on a 92 yo guy with 4++++ NS; he did not have any evidence of zonular laxity pre-op, but intra-op most of his zonules magically turned into dust. I watched that bad boy sink like an anchor. I was a chief at an outside hopsital at that time and I was doing all cases there; next day I got to use fragmetome and removed the nucleus from the back. That's what I call continuity of care 🙂

How many times have you or someone you know dropped a nucleus in residency (i.e retained fragments needing PPV)? Would appreciate honest answers...

 

[JMK2005]

I've had one dropped nucleus currently at about 180 primary cases. It doesn't happen too often to the other guys either.

 

[eyehope]

Full nucleus drop is probably uncommon. Have heard of 1-2/year out of 500-600 cases/year. Posterior capsular rupture with retained fragments a little more common. Posterior capsular rupture with retained cortex even more common. Happens to the best of us.

 

[HandofAlotia]

I had one of those- I've done about 160+ phacos. I've also torn 2 capsules (including a spectacular posterior polar during hydrodelineation- no lens loss). This 4+, PXF beast went deep-six on me while I was probably executing an overly aggressive crackin' move- headed for davy jones locker before all the lens was removed. Happened at the VA and, like posted before me, did the PPV a couple days later. He's sportin 20/20 BCVA w/ his ACIOL, so as much as it will always produce a code brown and should be avoided- it is not the end of the world. Oddest thing is this pt is my biggest fan because of all of the face time I put in with him. It definitely humbled me, and I learned a ton about when and when not to use aggressive stop-and-chop. Probably why I only had one.

I would say its hard to compare numbers as not all cataracts are created equal- if your doing trauma, PXF, uveitis, posterior polar cats all day at your program you can expect some extra OR time- its well know that our county hospital is where the Ant Vit is always on stand-by as this place produces some real nightmare caddys.

Another one of our residents said she thought "tearing the PC was part of the procedure" her first couple of cases- but she is great now.

 

[HandofAlotia]

I had one of those- I've done about 160+ phacos. I've also torn 2 capsules (including a spectacular posterior polar during hydrodelineation- no lens loss). This 4+, PXF beast went deep-six on me while I was probably executing an overly aggressive crackin' move- headed for davy jones locker before all the lens was removed. Happened at the VA and, like posted before me, did the PPV a couple days later. He's sportin 20/20 BCVA w/ his ACIOL, so as much as it will always produce a code brown and should be avoided- it is not the end of the world. Oddest thing is this pt is my biggest fan because of all of the face time I put in with him. It definitely humbled me, and I learned a ton about when and when not to use aggressive stop-and-chop. Probably why I only had one.

I would say its hard to compare numbers as not all cataracts are created equal- if your doing trauma, PXF, uveitis, posterior polar cats all day at your program you can expect some extra OR time- its well know that our county hospital is where the Ant Vit is always on stand-by as this place produces some real nightmare caddys.

Another one of our residents said she thought "tearing the PC was part of the procedure" her first couple of cases- but she is great now.