Cataract Surgery in Patient Who Sneezes-Reply

Abstract

In Reply.— Drs Gross and Hoffer recommend phacoemulsification cataract extraction for the patient described in the original question. I would agree that an extracapsular extraction is safer for this man, and I would prefer it to an intracapsular procedure. The question as to whether phacoemulsification is safer than a planned extracapsular is somewhat moot. It is true that phacoemulsification can be done through a 3-mm incision, but since we all agree that an intraocular lens is appropriate, the incision would have to be enlarged to 7 mm to insert the lens. Planned extracapsular cataract surgery can be done comfortably through a 10-mm incision. There may be some advantage to an incision 3 mm smaller, but I do not believe this is critical. The essential point is the one with which we all agree—an extracapsular procedure would be safer than intracapsular extraction. As to general anesthesia for this patient, I agree