part, to the cataract should be evaluated. While the existence of other sight-threatening diseases, such as age-related macular degeneration or glaucoma, does not preclude cataract surgery, less improvement may be expected in their presence. The eyes should have a normal pressure, or any pre-existing glaucoma should be adequately controlled with medications. In cases of uncontrolled glaucoma, a combined cataract-glaucoma procedure (phaco-trabeculectomy) can be planned and performed. The pupil should be adequately dilated using eyedrops; if pharmacologic pupil dilation is insufficient, procedures for mechanical pupil dilatation may be needed during the surgery. Patients with retinal detachment may be scheduled for a combined vitreo-retinal procedure, along with PCIOL implantation. It has been shown that patients taking tamsulosin (Flomax), a common drug for enlarged prostate, are prone to developing a surgical complication known as intraoperative floppy iris syndrome (IFIS), which must be correctly managed to avoid the complication posterior capsule rupture; however, prospective studies have shown that the risk is greatly reduced if the surgeon is informed of the patient's history with the drug beforehand, and has appropriate alternative techniques prepared. A Cochrane Review of three randomized clinical trials including over 21,500 cataract surgeries examined whether routine preoperative medical testing resulted in a reduction of adverse events during surgery. Results showed that performing preoperative medical testing did not result in a reduction of risk of intraoperative or postoperative medical adverse events, compared to surgeries with no or limited preoperative testing. Operation procedures The two most commonly used procedures are phacoemulsification and manual small incision cataract surgery (MSICS). Phacoemulsification The surgical procedure in phacoemulsification for removal of cataract involves a number of steps, and is typically performed under an operating microscope. Each step must be correctly performed to achieve the desired result. The steps may be described as follows: Anaesthesia and pupil dilation; Either topical, sub-tenon, peribulbar, or retrobulbar local anesthesia is used, usually causing little or no discomfort to the patient. Topical anesthetic agents are most commonly used and may be placed on the globe of the eye as eyedrops prior to surgery and or in the globe during surgery. Local anesthetic injection techniques include sub-conjunctival injections and or injections posterior to the globe (retrobulbar block) to produce a regional nerve block when it is necessary to prevent movement of the eye. Intravenous sedation may be combined with the topical and injection techniques. General anesthesia and retrobulbar blocks were historically used for intracapsular