1559: MSICS for weak K endothelium

Doing phacoemulsification surgery involves using ultrasonic energy and fluidic flow to break up and aspirate the cataract nucleus. Both the energy and the fluid can negatively affect the corneal endothelium, particularly in cases where it is weak to begin with such as Fuchs’ corneal dystrophy. Using a good dispersive viscoelastic can coat the endothelial cells and provide a good degree of protection, but with a dense cataract, that may not be enough. In the case shown here, our guest surgeon performs the MSICS technique to extract the nucleus through a much larger incision, however it is done with no ultrasonic energy and minimal fluidic flow. This allows preservation of the corneal endothelial cells and the patient can have an excellent outcome as soon as the day or two after surgery. Even the most experienced phaco surgeons should learn how to perform MSICS!

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