When we are operating on a younger cataract patients, the stakes are higher and the surgery must last the patient for many decades to come. This patient is about 40 years old and has developed a central nuclear density which has deteriorated the vision and induce many diopters of myopic shift.
For the refractive outcome, we are aiming for about -1.50 diopters of myopia in order to emphasize near vision with a central point of about 67 cm and a wider range on either side of that. This will be helpful for the patient’s near work which is primarily computer based with some paperwork. For the surgery, it is imperative that the incision is properly constructed while barely nicking the limbal blood vessels. This will ensure long-term sealing and stability far more than a totally avascular incision. The capsulorhexis must be precise, centered, and of the appropriate 5 mm diameter so that it securely holds the IOL optic for life.
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