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Traumatic Cataract and Mydriasis

A 68-year-old physician had suffered a bungee cord injury to his right eye 8 months prior to surgery. He had symptoms of bothersome glareand photophobia due to a traumatic mydriasis that left him with a pupil permanently dilated to 7 mm in diameter. Because a progressive cataract had impaired his vision to a level of 20/50, he elected to undergo cataract surgery. There was no preoperative phacodonesis. As this case illustrates, traumatic cataracts challenge surgeons to diagnose and manage intraoperative zonulopathy, optimize the IOL’s long-term fixation and centration, and consider or repair concomitant iris defects.

Comments (3)

This is just a personal preference, and there is no major advanatage. In general, I perform my CCC using an irrigating cystotome (#25 needle) because I get a better view. If creating the CCC is more challenging because of weak zonules, for example, then I would do this with a forceps under OVD to get more control. In this case, because I kept the CCC initially on the smaller size, it wasn't necessary to use forceps. Most surgeons will prefer to use forceps because it is easier to control the CCC.

DavidFChang (72 months ago)

Dr. Chang what are the advantages of performing capsulorrexis without OVD ? . Thanks for this magnifique video.

marcos (72 months ago)

impressive surgery, thanks!!

hita (75 months ago)