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Pillow case.

Marvin I Gordon¹, Andrés A Rodríguez, Michael D Olson

¹Department of Ophthalmology, David Geffen School of Medicine at the University of California, Los Angeles, California 90095-7002, USA.

Journal of Cataract and Refractive Surgery

|October 26, 2005

Summary

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Severe kyphosis poses challenges for cataract surgery. This case demonstrates a successful surgical positioning technique using pillows and reverse Trendelenburg for improved patient outcomes.

Area of Science:

Ophthalmology
Surgical Techniques
Patient Positioning

Background:

Severe kyphosis can impede patient positioning for ophthalmic procedures.
Cataract surgery requires precise alignment under the operating microscope.
Adequate visualization is crucial for successful surgical outcomes.

Observation:

An 80-year-old male patient presented with severe kyphosis and visually significant bilateral cataracts.
Previous cataract surgery was cancelled due to inability to position the patient adequately.
Patient could only elevate his head 30 degrees below the horizontal.

Findings:

Cataract surgery was successfully performed using a modified positioning technique.
The operating table was padded with 14 pillows (11 under the lower body, 3 under the head/neck).

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Maximum reverse Trendelenburg position was utilized to achieve a good red reflex.

Implications:

This case highlights an effective, low-cost method for positioning patients with severe kyphosis for ophthalmic surgery.
The described technique can improve surgical access and safety in challenging patient populations.
Successful management of complex positioning challenges can restore vision in patients with severe deformities.