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Amar Agarwal FRCS
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Amar Agawal presents a glued IOL surgery performed during the 2014 IIRSI Conference. Following conjunctival peritomy, two partial thickness scleral flaps are made 180 degrees opposite to each other. Sclerotomy incision is framed with a 20 G needle approximately 1.0 mm from the limbus, beneath the flaps. 23 G vitrectomy probe is passed from the sclerotomy incision and thorough vitrectomy is performed. A 3-piece foldable IOL is loaded and the tip of the IOL is kept slightly protruded from the cartridge. The tip is grasped with the Glued IOL forceps introduced from the sclerotomy incision and after the entire IOL is injected into the eye, the haptic is pulled and externalized. The trailing haptic is then grasped and is flexed into the eye. Handshake technique is performed and the trailing haptic is externalized from the other sclerotomy incision. The haptics are then tucked in the scleral pockets and vitrectomy is performed at the sclerotomy site to cut down vitreous strands. Air bubble is injected, infusion is stopped and fibrin glue is applied to seal the flaps.
Posted: 7/08/2014
Amar Agarwal FRCS
Amar Agawal presents a glued IOL surgery performed during the 2014 IIRSI Conference. Following conjunctival peritomy, two partial thickness scleral flaps are made 180 degrees opposite to each other. Sclerotomy incision is framed with a 20 G needle approximately 1.0 mm from the limbus, beneath the flaps. 23 G vitrectomy probe is passed from the sclerotomy incision and thorough vitrectomy is performed. A 3-piece foldable IOL is loaded and the tip of the IOL is kept slightly protruded from the cartridge. The tip is grasped with the Glued IOL forceps introduced from the sclerotomy incision and after the entire IOL is injected into the eye, the haptic is pulled and externalized. The trailing haptic is then grasped and is flexed into the eye. Handshake technique is performed and the trailing haptic is externalized from the other sclerotomy incision. The haptics are then tucked in the scleral pockets and vitrectomy is performed at the sclerotomy site to cut down vitreous strands. Air bubble is injected, infusion is stopped and fibrin glue is applied to seal the flaps.
Posted: 7/08/2014
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Gary Wortz, MD
11 years ago
This is a beautiful technique. What is the reason for leaving the air bubble in the anterior chamber at the end of the case?
Amar Agarwal
11 years ago
Gary, at the end we need to apply fibrin glue to seal the flaps. For that we need a dry area. We need to stop the infusion of fluid. This way the fluid will not be leaking through the sclerotomy where the glue has to be applied. In such a scenario we don't want any hypo tony on table and also post operatively. So we inject the air in the AC, this will prevent any hypotony on table and any choroidals post operatively. Amar Agarwal