What is the secret to patient fixation during surgery?

Many ophthalmologists have asked me how my patients are able to maintain fixation during cataract surgery under topical anesthesia. In order to successfully perform delicate steps like the capsulorhexis, we need the patient to hold still and maintain fixation. So what is the secret?

The secret is the script. I describe the microscope lights to the patients as a beautiful light show that is absolutely fascinating. As I describe the lights and the sensations, the patients are in awe and they keep staring right at the microscope lights. And this gives excellent fixation and centration of the eye.

Of course the patients also receive a mild degree of systemic sedation though the intra-venous line. This is typically a small dose of midazolam and rarely a small bolus of an analgesic medication.

Click below to see the video of a typical cataract surgery and more importantly, listen to my script. Throughout the video, I speak the same script that I use for my patients.

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