Pearl

Fluid, whether BSS or PFCL, condensation on the back surface of the IOL can significantly worsen the view. The surgeon can wipe it off with a blunt tool or “smear” a thin layer of dispersive visco on the IOL (see Fig. 25.2).

•Even in phakic eyes, the air will occasionally enter the AC.

– Either fill the AC with visco or readjust the BIOM front lens.

Working in the air-filled eye also has tangible benefits.

•The visual field increases under air, allowing access to peripheral areas that were out of view before. This is especially beneficial when extensive lasering is necessary in the periphery.

•The air allows safe vitreous removal in the periphery (pneumovitrectomy, see

Fig. 14.1 and Sect. 27.3.2).

31.3The Utilization of an Air Bubble

Air can also be employed for the following purposes.

•Demonstrating the presence of vitreous behind the posterior capsule (see Sect. 27.5.3).

•Demonstrating the presence of vitreous in the AC: the normal, perfect-sphere shape of the bubble is distorted if vitreous gel is present (see Sect. 63.6).

•Preventing the iris from prolapsing into a (paracentesis) wound (see Sect. 39.1).

•Preventing silicone from prolapsing into the AC (see Sect. 35.4.4).