title: Intraocular surgery in kyphosis: an easier approach.
abstract: We describe a 49-year-old man with advanced kyphosis and dense cataract, who could only recline to about 40° from the vertical axis despite a maximal reverse Trendelenburg position and pillows under the head, neck, shoulders and knees. With a single corneal retraction suture at 6 o'clock, the eye could be rotated horizontally, which enabled the surgeon to perform a complex cataract surgery despite prior glaucoma shunt, posterior synechiae, a small pupil and the need to stain the capsule. As the eye can be brought into any desired position with a retraction suture, patients with kyphosis or other conditions that prevent them from assuming a supine position can still have safe intraocular procedures. This maneuver reduces the need to tilt patients to an uncomfortable position that may cause pain, increased breathing difficulty and elevated posterior vitreous pressure.
authors.affiliation: Departments of Ophthalmology at University of Texas Southwestern Medical Center, USA.
authors.forename: Karanjit S
authors.initials: KS
authors.lastname: Kooner
authors.forename: Felise M
authors.initials: FM
authors.lastname: Barte
keywords: Intraocular complications; Intraocular surgery; Kyphosis
references.citation: J Cataract Refract Surg. 2000 Aug;26(8):1258-60
references.pmid: 11008060
references.citation: J Cataract Refract Surg. 1996 Dec;22(10):1408-10
references.pmid: 9051493
references.citation: J Cataract Refract Surg. 1995 Jul;21(4):364
references.pmid: 8523272
references.citation: J Cataract Refract Surg. 1994 May;20(3):353-4
references.pmid: 8064616
references.citation: Indian J Ophthalmol. 1974 Mar;22(1):35
references.pmid: 4448534
references.citation: J Cataract Refract Surg. 2005 Sep;31(9):1824-5
references.pmid: 16246791
references.citation: J Cataract Refract Surg. 1995 Mar;21(2):111
references.pmid: 7791042
references.citation: J Cataract Refract Surg. 1995 Jan;21(1):5-6
references.pmid: 7722903