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Amar Agarwal FRCS
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Dr. Amar Agarwal presents a lens coloboma case with implantation of a multifocal lens using the glued IOL technique. Using the handshake technique, a three-piece multifocal intraocular lens is inserted and both haptics are externalized through sclerotomies. After the lens is stable and well-centered, the scleral flaps and conjunctiva are reposited with fibrin glue.
Posted: 10/25/2011
Amar Agarwal FRCS
Dr. Amar Agarwal presents a lens coloboma case with implantation of a multifocal lens using the glued IOL technique. Using the handshake technique, a three-piece multifocal intraocular lens is inserted and both haptics are externalized through sclerotomies. After the lens is stable and well-centered, the scleral flaps and conjunctiva are reposited with fibrin glue.
Posted: 10/25/2011
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pedro victor de miguel simo
13 years ago
Thank you for your explanation. I 'm vitreo-retinal surgeon and I 'd learn a lot of yours videos. Last month I tried to use your tecnich in a PCL luxated with succes. Thank you professor.
Amar Agarwal
13 years ago
The air bubble will prevent any postoperative hypotony the next day. Also we take off the fluid cannula and put the air bubble inside. This way we will not have fluid coming out of the sclerotomy site. This helps the fibrin glue to work well as the area should be dry when the glue is applied. The third reason the air helps is that in any case where there is a pc rupture Or a worst case scenario if there is a descmets detachment the air will help fix that too. One does not need any iridectomy in glued IOL surgeries as the IOL is in the position where the normal PC IOL is placed. Amar Agarwal
pedro victor de miguel simo
13 years ago
Thank you Dr. Agarwal for yours teahing. I have a question: Would not be better pars plana approach for lensectomy. We would make a complete vitrectomy and we could check the retina at the end of surgery.
Amar Agarwal
13 years ago
Pedro Victor, One could do a pars plana lensectomy and check the retina if one is a vitreoretinal surgeon. But if one is an anterior segment surgeon then it is difficult. If I have a case which requires retinal management I would do a a pars plana lensectomy. In the case shown, that was not required. Certain points to note are- 1. Every phaco machine has a good anterior vitrectomy setup which can be used to do lensectomy. Those are 20 gauge probes generally. In such cases one can do the lensectomy from the clear corneal incision. if one has a posterior vitrectomy machine then the best would be to use a 23 gauge vitrectomy probe which could pass through the sclerotomy under the scleral flap. This way an extra sclerotomy in the pars plana is not made. 2. When one does a lensectomy, do it like a rat nibbling a piece of cheese. This means start doing lensectomy from one end of the lens and continue it till you reach the other end of the lens. This way small small piece would not fall down into the vitreous cavity. 3.Use always an AC maintainer or an infusion cannula so that fluid is always inside the eye when doing the procedure. Amar Agarwal
nathaniel ruttig
13 years ago
what is the purpose of the air bubble, and would this patient need a Peripheral iridotomy/iridectomy?
Nikoloz Labauri
13 years ago
THANK YOU FOR NICE VIDEO. WHAT KIND OF LENS DO YOU USE HERE ?( COMPANY ? )