We often will move the positions of our incisions to provide a better result for the patient or a more ergonomic approach for the surgeon. We like to make our phaco incision on the steep corneal axis since this will help address the pre-existing astigmatism. Sometimes, this also means placing our incisions in close proximity to the eyelid speculum. If we find that our instruments are hitting the arms of the speculum, we can rotate the speculum by a clock-hour (30 degrees) or so in order to provide more room.
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