W.S., a 68-year-old woman, was scheduled for surgery for a cataract and relief from "floaters", which she had noticed in her visual field since her surgery for a retinal detachment last year. She reported to the ambulatory surgery center an hour before her scheduled procedure. Before transfer to the operating room, she spoke with her ophthalmologist and reviewed the surgical plan. Her right eye was identified as the operative eye and it was marked with a "yes" and the surgeon's initials on the lid. She was given anesthetic drops in the right eye and an intravenous bolus of 2.0 mg of midazolam (Versed).

In the OR, W.S. and her operative eye were again identified by the surgeon, anesthetist, and nurses. After anesthesia and akinesia were achieved, the eye area was prepped and draped in sterile sheets. An operating microscope with video system was positioned over her eye. A 5-0 silk suture was placed through the superior rectus muscle to retract the eye. A lid speculum was placed to open the eye. A minimal conjunctival peritotomy was performed, and hemostasis was achieved with wet-field cautery. The anterior chamber was entered at the 10:30 o’clock position. A capsulotomy was performed after Healon was placed in the anterior chamber. Phacoemulsification was carried out without difficulty. The remaining cortex was removed by irrigation and aspiration.

An intraocular lens (IOL) was placed into the posterior chamber. Miochol was injected to achieve papillary miosis, and the wound was closed with one 10-0 suture. Subconjunctival Celestone and Garamycin were injected. The lid speculum and retraction suture were removed. After application of Eserine and Bacitracin ointments, the eye was patched and a shield was applied. W.S. left the OR in good condition and was discharged to home 4 hours later.

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