I had a case were all your scare comes true. A perfect round endotelial capsulorrexis, but I was not lucky enought to found the endotelium at the end of the case. Good illustration of what can really hapen¡¡
ranchump and Mehdi Ghajar you are both correct. Following capsulorhexis I will make an effort to remove the capsule but failed in this case. If the capsule is slippery I won't spend time going after it because it almost always comes out during phaco. Clearly, in this surgery, the entire anterior capsule remained in the eye, intact and found its way to the posterior cornea.
James Lewis
(36 months ago)
still don't understand how the anterior capsule was left in the eye after the rhexis. doesn't everybody pull it out?
ranchump
(36 months ago)
Dr. Lewis you need to explain to the viewer in the video that you are pulling out the anterior capsule not Descemet's or a previously grafted (DSAEK) eye. It is a bit confusing unless you read the comments.
Mehdi Ghajar
(36 months ago)
If the capsule can protect the endotelium it could be a breaktrough in cataract surgery!
ZMario
(37 months ago)
I think you had wait before remove the capsule out of the eye, because if it was endothelium you could place it like a DSAEK with a bubble air into the anterior chamber
Giorgio
(38 months ago)
wait a sec- how did the anterior capsule stay in the eye after the rhexis? don't you pull it out when the rhexis is completed?
ranchump
(38 months ago)
It looked just like a perfect endothelial disaster. but as you said, too perfect. It was the anterior capsule masquerading as an endothelial defect. I pulled out the anterior capsule, the endo was intact and the patient signed up for his other eye.
James Lewis
(38 months ago)
how did the case have a happy ending? how did the descemet's get torn in such a perfectly round manner?
Comments (9)
I had a case were all your scare comes true. A perfect round endotelial capsulorrexis, but I was not lucky enought to found the endotelium at the end of the case. Good illustration of what can really hapen¡¡
ranchump and Mehdi Ghajar you are both correct. Following capsulorhexis I will make an effort to remove the capsule but failed in this case. If the capsule is slippery I won't spend time going after it because it almost always comes out during phaco. Clearly, in this surgery, the entire anterior capsule remained in the eye, intact and found its way to the posterior cornea.
still don't understand how the anterior capsule was left in the eye after the rhexis. doesn't everybody pull it out?
Dr. Lewis you need to explain to the viewer in the video that you are pulling out the anterior capsule not Descemet's or a previously grafted (DSAEK) eye. It is a bit confusing unless you read the comments.
If the capsule can protect the endotelium it could be a breaktrough in cataract surgery!
I think you had wait before remove the capsule out of the eye, because if it was endothelium you could place it like a DSAEK with a bubble air into the anterior chamber
wait a sec- how did the anterior capsule stay in the eye after the rhexis? don't you pull it out when the rhexis is completed?
It looked just like a perfect endothelial disaster. but as you said, too perfect. It was the anterior capsule masquerading as an endothelial defect. I pulled out the anterior capsule, the endo was intact and the patient signed up for his other eye.
how did the case have a happy ending? how did the descemet's get torn in such a perfectly round manner?