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Adjusting the table to a Trendelenburg position can, in certain instances, facilitate the deepening of the AC by utilizing gravity to displace intraocular contents posteriorly ( Utilization of Eye Speculum: Choosing a suitable speculum for patients with deep-set eyes to guarantee complete visibility of the surgical area while avoiding excessive strain on the globe ( A secondary device (e.g., chopper or cyclodialysis spatula) is employed to stabilize the globe or retract tissue, which may be essential for enhanced control ( Decreasing vitreous pressure Honan Intraocular Pressure Reducer: The Honan balloon is a device applied externally to the eye to provide gentle compression, thereby reducing IOP before surgery ( Preoperative Intravenous Mannitol: Mannitol is an osmotic diuretic administered intravenously to decrease IOP by drawing fluid out of the vitreous body ( Limited Anterior Vitrectomy: This surgical procedure involves removing a portion of the anterior vitreous to alleviate vitreous pressure, particularly in cases where vitreous prolapse occurs during cataract surgery or other anterior segment procedures ( Hyperopic eyes with a shallower anterior chamber and positive posterior pressure may respond less favorably to peribulbar or retrobulbar anesthesia due to increased risk of globe compression and shallow chamber collapse

doi:10.1084/jem.20092506

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Wagner and Knig, 2012