Face-to-face seated positioning for phacoemulsification in patients unable to lie flat for cataract surgery

To describe a technique of phacoemulsification for patients unable to lie flat.

Prospective interventional case report.

Two patients unable to lie flat during phacoemulsification underwent this technique in a University Ophthalmology Department in the United Kingdom. Each patient was positioned erect or semirecumbent in a standard reclining cataract surgical chair. The ceiling-mounted microscope was rotated 60 degrees from the vertical to point toward the patient. The surgeon sat beside the patient, and while facing him or her, operated at nearly arm's length.

The intraoperative and postoperative periods were uneventful in both patients, with good visual outcomes after surgery.

This technique is valuable for situations where the patient or the eye requires upright positioning because of the inability to recline flat, and should be considered for cases where standard surgical positioning is not possible.