Completing Surgery With a Compromised Rhexis
If the capsulorhexis has been torn during cataract surgery while the nucleus is still in the bag, then you are faced with the sizeable challenge of completing surgery without the tear extending around to the posterior capsule. Brian Little, MD, covers in practical detail some of the techniques that enable safe removal of the cataract and allow IOL implantation when the capsulorhexis has been compromised. The techniques depicted are viscoexpression, ECCE, endocapsular phaco, and management of the Red hole in the nucleus.
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Comments (3)
Inserting a small AC maintainer may also help to keep positive pressure in the AC throughout the surgery..esp helping during exchange of instruments
I think rhexis relaxing incisions are the key for success in these cases either completing iris plane phaco or ECCE
Corydon Cannula (right or left handed) is very useful for gentle hydro or viscodissection of the sub-incisional part of the lens out of the compromised bag and into the AC where it can be phaco removed, or removed with irrigating vectis.Miss P. McGettrick