On yesterday’s Cataract Coach Podcast (the top podcast in all of ophthalmology!) we learned some great surgical pearls from our guest, Dr John Jarstad. The “zombie” double tap is a cataract surgery technique designed to normalize intraocular pressure (IOP) and eliminate post-operative pressure spikes. (The zombie reference is related to American zombie movies where a double tap of your weapon is recommended to neutralize the attacking zombie!) To perform this, the surgeon fills the AC with BSS at the end of the case. Then a 27-gauge cannula is then quickly inserted and removed from the paracentesis twice. This rapid “double tap” allows excess fluid to egress, consistently resulting in an IOP between 16 and 21 mmHg. Beyond preventing pressure spikes, a study of this technique showed a significantly lower incidence of cystoid macular edema (CME).
The bonus clip here is the “fisherman’s knot” which is an iris repair technique inspired by a commercial fishing clinch knot. To execute it, the surgeon pulls a suture loop out of the eye, twists the loop itself five times, passes the needle through the twisted loop, and pulls it across. An additional twist and a “back throw” create a secure locking knot. This method provides a reliable alternative to traditional knots that may untie.
Dear Professor,
what about cefuroxime concentration after the double tap?
Best regards
Carlo