A little microburst goes a long way

Since introducing femtosecond laser-assisted cataract surgery, or FLACS, to my weekly cataract armamentarium 4 years ago, I have gone through many procedural changes to optimize patient visual outcomes in terms of faster visual recovery time, reduced inflammation and reduced corneal edema.As premium cataract surgeons, we should always seek ways to reduce the cascade of events that cause surgical stress during cataract surgery, a process that we know begins before incision creation followed by the well-known arachidonic cascade of inflammation and finally ends with postoperative corneal edema. The ultimate goal in cataract surgery is to perform the procedure with minimal disruption to other tissues, with minimal to no heat/thermal damage, and reduced phacoemulsification time and reduced volume of irrigation and aspiration fluid. Preoperative cataract density based on the LOCS III classification system has a direct impact on all of these variables, and techniques for gentler cataract surgery are critical to get to the best visual outcome. Below I will describe various techniques and ultimately the newer and ever more popular microburst phacoemulsification technique used in conjunction with FLACS to get these immediate results.