Piercing the Darkness - Cataract Surgery on a Blind Eye
An injury more than 25 years ago resulted in a blind eye, but a recent vascular event in the fellow eye which left this patient completely blind compelled Alan Aker, MD, to operate on what was considered an inoperable cataract. The pupil is mechanically stretched with a Pupil Beeler Iris Retractor and OVD. A can-opener capsulotomy is performed but scissors are needed to cut away the fibrotic capsule. After a phaco-flip technique is used to remove the dense cataract, an IOL is inserted.
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Comments (11)
This case was done before Trypan was available. I'm not sure iris clips were available, but if faced with a similar case today, I would definitely use both!
Great Case, even though it was a traumatic cataract and a tough case, it should not be deemed inoperable if the pt has light perception vision. It's unfortunate that the surgery was put off because it was deemed "inoperable."
A good case for a Malyugin Ring
if there is light perception, we should't give up
I would like to congratulate Dr Aker for showing his very interesting surgical video. It shows how modern technology can help to carry out in safety surgical interventions deemed impossible in the past. Obviously, the surgeon who approaches such interventions must also have an appropriate experience. As Dr. Aker pointed out, it is truly a blessing to be able to help someone. The detractors may argue that the real reason is the desire to perform a surgical execise, whereas it is rather giving a certain quality of life back to these unfortunate patients. The motivation of the patient must be superior to the fear of intraoperative complications and unpredictable visual outcome, and therefore only rarely they undergo surgery. Well done Dr Aker! Gianluca Carifi, MD
Thanks for your comments. Trypan Blue has certainly made my life easier, but this case was done when I first got my Millennium from Bausch and Lomb and Trypan was not available at that time. Post op vision was 20/400 which enabled him to get around. He regained the ability to eat and dress himself. He was essentially totally blind prior to this procedure. It is truly a blessing to be able to help someone by what we are so privileged to do.
Nice case, congrats!!
Greetings! Blue trypan will make your life easier!! Nice case.
surprised did not use tryptan, and did not tamponade the eye with viscoat for a few minutes to stop the bleeding. iris hooks might have been helpful, too.
Hello Dr Aker! What was the VA after the surgery? Thanks!
This is a case for a small incision EECC.