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Robert Weinstock MD
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Robert Weinstock, MD, shares a case of unintended posterior capsular tear. Trypan blue is instilled to stain capsule in the dense cataract with fibrous capsular membrane. The rhexis starts to run peripherally but Dr. Weinstock is able to complete a 360 degree capsulorhexis. Using the irrigating chopper, he deconstructs the quadrants with a combined cracking and chopping technique with high vacuum. The surgeon notes the hallmark sign of a compromised posterior capsule, but with the bimanual technique and keeping irrigation superiorly, all the nuclear fragment remain high in the anterior chamber. After all nuclear fragments are removed, Dr. Weistock performs a limited anterior vitrectomy.
Posted: 6/25/2012
Robert Weinstock MD
Robert Weinstock, MD, shares a case of unintended posterior capsular tear. Trypan blue is instilled to stain capsule in the dense cataract with fibrous capsular membrane. The rhexis starts to run peripherally but Dr. Weinstock is able to complete a 360 degree capsulorhexis. Using the irrigating chopper, he deconstructs the quadrants with a combined cracking and chopping technique with high vacuum. The surgeon notes the hallmark sign of a compromised posterior capsule, but with the bimanual technique and keeping irrigation superiorly, all the nuclear fragment remain high in the anterior chamber. After all nuclear fragments are removed, Dr. Weistock performs a limited anterior vitrectomy.
Posted: 6/25/2012
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Just Now
Diclehan Ali Dicle
13 years ago
Nice surgery
Diclehan Ali Dicle
13 years ago
Nice surgery
Boris Ovodenko
13 years ago
Dr. Weinstock: What's the name of forceps you had used to stabilize the globe in the beginning of your video?
ari weitzner
13 years ago
thats colibri forceps, upside down i think
ari weitzner
13 years ago
after you notice the hole, you engage the proximal heminucleus (at app 3;28), which probably was a mistake, as it probably enlarged the rent as it tumbled a little. also, not sure if you edited it out, but once the rent was recognized, i would have injected viscoat, then remove phaco, re-assess, and the continue phaco over the viscoat under low-flow settings. also, i like to use the vitrector to do cortex, using ia/cut setting, which acts like a regular i/a in foot position 2, and if vit gets caught, just go to fp3 and do vitrectomy. lastly, in high risk case like this, i would have used malyugin ring. anyway, thats my brilliant hindsight! nice case and nice save!