Phaco Tip 148:
Topical Anesthesia and the Photophobic Patient

The above was the topic of a previous Phaco Tips column (Phaco Tip 96: The NLP technique). Some patients are so photophobic, however, that it is nearly impossible to make the small sideport incision necessary to over-inflate the globe and thereby create the temporary condition of no light perception as described in that column.

In such a situation, it is a simple matter to simply place the index finger of one hand above the pupil and thereby obstruct the microscope light from entering the eye. This will permit the patient to maintain enough fixation so that a sideport incision can be created at the inferior limbus. The requisite injection into the anterior chamber to accomplish the NLP technique can then be performed.

* Phaco Tip TM of Richard J. Mackool, M.D.

The parameters (instrument settings) and incision size presented here have been established by the surgeon and do not reflect recommendations by Alcon.