Phaco with Weak Zonules, 4+ NS
Dr. David Chang illustrates multiple strategies for these challenging cases including capsular dye, capsule retractors, vertical phaco chop, bimanual I/A, dispersive OVD to prevent capsular incarceration, delaying CTR insertion, and sulcus fixation of a PC IOL.
6,116 video views and 47,924 series views since 11/29/2009
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Phaco with Weak Zonules, 4+ NS
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Prechopping, Torsional Ultrasound, and Centration on the IOL
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Positioning Toric IOLs
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Four Pearls for Keeping Routine Surgery Routine
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Complete Cortical Removal with J-Cannula (In 30 Seconds or Less)
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Enhancing My Practice Through Video
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Advice for Easier Surgery and More Comfortable Patients
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MICS with Crystalens HD Implant
Comments (7)
I saw this last night. This morning I had a pseudoexfolation case with loose zonules. I tried your technique after a quarter of the capsule came loose. I used two hooks, worked like a charm, cleaned up the capsule, put in the CTR and placed the lens in the sulcus, optic captured by the bag. Thanks for a great day.
I have used this technique on a number of occasions. The Trypan Blue stained anterior capsule seems more brittle and on 2 cases "cheese wired" through the anterior capsular rim. Has anyone seen this? Also a cruise control (Staar Surgical) is very helpful in diminishing posterior capsular movement (in addition to lowering vacuum- flow levels). Do you consider using a Cionni Ring is these cases of severe PXE?
thank you for an excellent video
Excellent.
wich lense did you used?
too hard on the cornea. chang's approach much better
As an alternative, after the nucleus is loose, why not move it into the anterior chamber and do the phaco to avoid pressure on the zonules with the in-the-bag removal?