Weak Zonules: Capsule Retractors
A monocular 75-year-old presents with very weak zonules and develops a zonular dialysis during phacoemulsification. David Chang, MD, uses the Mackool Capsular Retractors (FCI-Ophthalmics, Marshfield Hills, MA) to hold the the bag forward during nucleus removal. The bag is filled with a dispersive OVD to protect the posterior capsule during bimanual cortex removal. A CTR is placed prior to removing the Mackool Capsular Retractor and an IOL is placed in the sulcus stabilize the lens against the cilliary body.
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Comments (2)
I always start with a CTR to assess bag stability. I may insert the IOL into the bag at this point. Even if using a 3-piece IOL in the sulcus, you still want to avoid the bag from contracting (due to insufficient centrifugal zonular counter traction) into a crumpled up capsular mass.
Why would you bother to insert a CTR if you are putting a PCIOL in the sulcus?