Decentered IOL
Robert Osher, MD, uses micro-coaxial torsional ultrasound to sculpt and chop the nucleus. After an uneventful first half, the case turns puzzling when then toric IOL refuses to center. Dr. Osher deduces that the cause of decentration is zonular weakness which is resolved with a CTR.
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Comments (2)
If you try to go back, right before IOL implantation, there was not enough viscoelastic in the bag such that the anterior leaflet collapsed onto the posterior capsule. This can be observed as soon as the IOL slides into the bag with a bit of anterior chamber collapse. This may have been averted if there was enough cohesive Na Hyaluronate in the capsular bag. Hence right after the ring was inserted this may have separated the fused anterior and posterior chambers. I didn't see that much zonular dehiscence during the procedure. But inflating the bag under the IOL with Na Hyaluronate and rotating the lens thereafter may have solved the problem. IMHO
very very informative