FP47

Adapting Cataract Surgery for Systemic, Postural, and Behavioural Challenges: A Case Series

Study design: Retrospective case series.
Purpose: To describe adaptations that enable safe cataract surgery in patients with complex systemic or functional limitations.
Methods: Six patients had morbid obesity with supine desaturation, severe kyphosis, oral cancer with a Ryle’s tube, titubation, psychiatric illness, or intraoperative chest pain. Assessment included systemic stability, positioning tolerance, airway concerns, and cooperation.
Results: Semi-recumbent positioning, head and neck support, altered microscope and surgeon height, accessible draping, regional anaesthesia with minimal sedation, and a brief standard procedure were used. Team briefing defined risks, rescue plans, and stopping criteria. The patient with chest pain was stabilised and transferred for cardiac care after surgery.
Conclusions: 
Comorbidity alone should not exclude cataract surgery. Individualised positioning, anaesthesia, and teamwork can improve safety.