Channels: Cataract Surgery | Posted 8/18/2015
Soosan Jacob, MS, FRCS, DNB, demonstrates her technique of a glued capsular hook for sutureless transscleral fixation of the capsular bag. A scleral flap is created centered on the dialysis. A capsular hook is modified by changing the bend in the shaft 90° to the shaft. This is then inserted transsclerally under the iris and above the capsular bag to engage the capsulorrhexis rim. The bag is then further stabilized vertically with additional translimbal capsular hooks and horizontally with a CTR for equatorial forniceal expansion. Phacoemulsification is carried out with in-the-bag IOL implantation. The translimbal hooks are then removed, and the transscleral hook is trimmed and tucked into an intrascleral Scharioth tunnel created at the edge of the scleral flap. The centration is adjusted by adjusting the degree of tuck of the haptic into the tunnel. The flap and conjunctiva are stuck down with fibrin glue. This technique can also be used for subluxated in-the-bag IOLs. It allows faster and easier surgery and a greater degree of adjustability for centration. This approach also eliminates the need to pass long and thin needles across the anterior chamber. Dr. Jacob has a patent pending for modified versions of the glued capsular hook.
Capsular Tension Rings, CTRs • Cataract • Cataract Surgery • Fibrin glue • Zonules