This patient has severe orthopedic spine issues along with other systemic medical conditions which prevent him from being in the supine position that we prefer for phaco cataract surgery. Our guest surgeon decides to perform seated upright phaco surgery by placing the patient’s head in a support (much like with your slit-lamp microscope) and adjusting the surgical microscope to achieve a reasonable view. The surgeon is having to place his own head in an awkward position just to be able to perform this case. Other challenges include making a nasal phaco incision (right handed surgeon and right eye of this patient) and the effect of gravity pulls things down to the inferior angle in the AC instead of posterior towards the capsule. Everything goes well and the patient achieves a great outcome. Great job!
