Board Certified Ophthalmologist Board Certified Ophthalmologist Lens and Cataract Questions and Answers 2 — Questions and Answers
Question 1: A 72-year-old patient with a mature white cataract undergoes phacoemulsification. During surgery, the capsular bag is noted to have significant zonular weakness. Which device is most appropriate to stabilize the capsular bag?
- Capsular tension ring (Correct answer)
- Ahmed glaucoma valve
- Anterior vitrectomy cutter
- Iris retractor hooks
Correct answer: Capsular tension ring
A capsular tension ring redistributes zonular stress and stabilizes the capsular bag during phacoemulsification in eyes with zonular weakness.
Question 2: Which type of intraocular lens (IOL) is most appropriate for a patient with significant corneal astigmatism undergoing cataract surgery?
- Toric IOL (Correct answer)
- Monofocal IOL
- Multifocal IOL
- Accommodating IOL
Correct answer: Toric IOL
Toric IOLs are specifically designed to correct pre-existing corneal astigmatism at the time of cataract surgery.
Question 3: A patient presents with a small, round, white opacity on the anterior lens capsule following a resolved episode of acute angle-closure glaucoma. What is this finding called?
- Glaukomflecken (Correct answer)
- Vossius ring
- Mittendorf dot
- Elschnig pearls
Correct answer: Glaukomflecken
Glaukomflecken are small anterior subcapsular lens opacities caused by focal ischemic necrosis of the lens epithelium during an acute angle-closure attack.
Question 4: During biometry for IOL power calculation, which formula is generally considered most accurate for eyes with an axial length shorter than 22 mm?
- Hoffer Q (Correct answer)
- SRK/T
- Holladay 1
- Haigis
Correct answer: Hoffer Q
The Hoffer Q formula has been shown to be more accurate for short eyes with axial lengths under 22 mm compared to other third-generation formulas.
Question 5: A 65-year-old diabetic patient develops visually significant posterior subcapsular cataract. Which characteristic is most typical of posterior subcapsular cataracts?
- Significant glare and difficulty reading in bright light (Correct answer)
- Painless progressive myopic shift only
- Superior visual acuity in dim lighting conditions
- Monocular diplopia without any glare symptoms
Correct answer: Significant glare and difficulty reading in bright light
Posterior subcapsular cataracts cause prominent glare and near vision difficulty because the opacity sits at the nodal point of the lens.
Question 6: What is the most common complication following Nd:YAG laser posterior capsulotomy for posterior capsule opacification?
- Elevated intraocular pressure (Correct answer)
- Retinal detachment
- Cystoid macular edema
- IOL subluxation
Correct answer: Elevated intraocular pressure
Transient elevation of intraocular pressure is the most frequent complication after Nd:YAG capsulotomy, typically occurring within the first few hours.
Board Certified Ophthalmologist Board Certified Ophthalmologist Lens and Cataract Questions and Answers 2
A 72-year-old patient with a mature white cataract undergoes phacoemulsification.
During surgery, the capsular bag is noted to have significant zonular weakness.
Which device is most appropriate to stabilize the capsular bag?