1283: The “I&A only” Soft Cataract

This young patient developed a cataract after trauma. Fortunately, the zonular support is great and the long term stability of an IOL should be fine. Both eyes started at -4 of myopia and you did LASIK for the other eye and it ended up plano with 20/20 distance vision. That eye also has the great accommodation of a 30 year old patient. For this eye with the cataract, what do you choose? Monofocal IOL? EDOF? Trifocal? And what refractive target? Plus what precautions are needed and what are the challenges in this very soft cataract? The issue is not going to be phaco power since you don’t even need the phaco probe. The entire nucleus can be removed with just the I&A probe.

click for some great pearls about achieving success in this type of case:


  1. do you have a cutoff in ac depth or axial length at which point you would consider the eye too small to use this technique?

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