The latest episodes of the ESCRS IME Phaco Complex Case Series spotlight two challenging cataract cases in very elderly patients, offering valuable surgical insights and practical pearls for managing high-risk eyes.
Managing a Dense Brunescent Nuclear Cataract
In this episode, Dr. Koen Willekens discusses the management of a rock-hard, brunescent cataract in a 93-year-old patient. He walks through his surgical approach, detailing the careful step-by-step modifications used to enhance safety in fragile, elderly eyes.
Dr. Willekens emphasizes the importance of:
- Small, deliberate intraoperative adjustments
- Controlled phaco techniques
- Close postoperative follow-up in very elderly patients
The case demonstrates how thoughtful planning and measured execution can lead to excellent visual outcomes — even in high-risk scenarios.
Low-IOP Fluidics Strategies in PXF-Related Zonulopathy
In a second complex case, Prof. Biljana Kuzmanović Elabjer presents cataract surgery in an 85-year-old patient with advanced pseudoexfoliation (PXF) syndrome. The case features a dense black cataract, phacodonesis, a small rigid pupil, and a shallow anterior chamber.
Prof. Elabjer outlines her step-by-step approach and demonstrates how low-IOP strategies can help reduce:
- Iris trauma
- Corneal edema
- Endothelial cell loss
- Postoperative inflammation
These cases reinforce the importance of tailored surgical planning and meticulous technique when managing complex cataracts in elderly patients.
Don’t miss the full episodes of the ESCRS IME Phaco Complex Case Series.
Independent medical education supported by Alcon and ZEISS.
