There is a lot to be learned from slow-motion analysis and this applies to cataract surgery as well. Think of a droplet hitting a still water surface: it’s only when we slow down the motion that we see the details and understand the intricacies of what happens.
Watching an expert surgeon do a cataract surgery is a beautiful ballet with precision, efficiency, and a paucity of movements. But there are so many subtleties in the surgery that the details can be difficult for beginning surgeons to understand. By slowing down the video we can see the small movements that are the basis for these techniques. Something as simple as creating a paracentesis incision is actually more involved and planned than it would appear.
Here are the steps that we want to highlight in the slow motion video:
- creation of the paracentesis
- injection of dispersive viscoelastic to do a visco-fluid exchange in the AC
- puncturing the anterior lens capsule with a cystotome
- making the main phaco incision
- capsulorhexis creation
- hydro-dissection of the lens nucleus
- phaco combo-chop technique
- embedding the phaco probe into the nucleus
- placement of the chopper
- cracking the nucleus into two separate halves
- sub-chopping nuclear halves
- rotating the nuclear pieces within the capsular bag
- using subtle motions of the phaco probe and chopper to remove nuclear bits
- IOL insertion and rotation in the capsular bag
- hydration of the incision to seal it
Study the slow-motion video below to get my feedback during these crucial steps of the surgery. And then watch the next video which shows the original surgery in real-time.
The slow-motion video with full instruction is here:
The original video is here unedited and in real-time: