Do not vacuum near the corneal endothelium

During cataract surgery, you notice a small lens fragment or an air bubble float up to the corneal endothelium, where it just sits. It partially blocks your view and it seems like an irritation to you. The temptation is to use the phaco probe to vacuum away these distractions from the corneal endothelium — but you should resist this urge in most cases. Applying vacuum close to the corneal endothelium with the phaco probe will remove the protective dispersive viscoelastic and may increase cell loss.

If the lens material or air bubble is relatively small, the best option is usually to ignore it. If the material is larger, then using more viscoelastic can displace it. For air bubbles, using a 27ga cannula on a syringe to aspirate the gas is more precise and gentler.

Click below to learn the safest approach to dealing with this situation:

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