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Thanks for sharing this! good save, and well narrated.

Thanks for sharing. After removal of the Akreos, inflating the sulcus w/ a COHESIVE OVD would have created more space so that the leading haptic would have been in the sulcus. It looks that the sulcus may have not been adequately inflated. I enjoyed the video. Lots of good teaching points.

Great teaching video. It's the complicated cases that we really learn from. Thank you.

Thanks for posting this video Dr. Hirschfield - excellent management of a difficult problem that we all encounter

very good

in hindsight, perhaps i would have placed the trailing haptic into the sulcus, and then dialed the lens and thus getting the nasal haptic into the sulcus.

thanks , for this video. Dr Gary Hirshfield

I belive I used an MA60, 6 mm 3 piece lens

what IOL is used to implant in sulcus? which model #of acrysoft?

just make sure the akreos doesnt behave badly in sulcus like the acrysof. i just saw a pt done elsewhere with bad ugh syndrome from acrysof in sulcus.

Thank you, great idea. I call that reverse iris capture I am not sure if the akreos would be stable and not slip back into the bag but it definitely would be worth a try and then to evaluate the stability intraop. Thank you next time I'll try that.

Thanksfully you had a Lumera, when dealing with capsules it makes a huge difference. One question, the rexis looks small enought to capture an Akreos with one hatic in sulcus, next in the bag, next sulcus and last in the bag. I´ve tried it once, the result was -0,75 because of the more anterior position of the lens, one year later the lens is stable with fibrosis securig the "bag in the lens" position as pioneered by Dr. Tassignon.

thanks, I've gotten experienced at fixing "goofs" I frankly don't know if that's a good thing!! I agree an acrysof would have been a much safer less traumatic insertion but the Akreos would have been find had I done a more careful atraumatic insertion. In future cases like this I will go the the one piece acrysof.

only good surgeons post their goofs- thank you dr. h.

nice movement...good video. thanks for show this kind of complication. i could lern how to pick up the aptic fron the bag. thanks

These cases get 500 mg po Diamox post op and again at night along with Combigan BID. That plus the miochol yielded a 1 day post op pressure of 15.

Good recovery. There was a ton of viscoat left behind. How was the pressure?

Gary, don't worry, good job.

Eye doctor

Gary,

Very poor quality video recording. It keeps cutting out