1484: phaco before vitrectomy surgery

This patient has visually significant cataracts in both eyes and a full-thickness macular hole in one eye. I have already done the cataract surgery of the first eye and the patient did very well, electing for a monofocal IOL and a refractive goal of -2.00 to optimize near vision. For this eye, we are planning the same IOL and refractive outcome but we must take into account that the patient will undergo a pars plana vitrectomy and membrane peel for the macular hole in a few weeks. How should we tailor our cataract surgery to produce a better result for the anticipated retina surgery? It starts with the incision which must stay sealed even if the vitreous cavity is pressurized with a gas bubble. We must also ensure that the IOL stays within the capsular bag even if there is posterior pressure from the gas bubble. This video gives my best pearls for performing cataract surgery in an eye that is scheduled for a pars plana vitrectomy in the near future.

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