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The Prodigal Haptic Eyetube - Good Surgery May Not Always Give Ideal Outcomes

  Channels: Cataract Surgery | Posted 10/4/2010

Following uneventful and IOL implantation about a year ago, this lady had a good visual outcome. However she then experienced recurrent anterior uveitis over the next few months. Slit lamp examination showed some iris thinning in the infero temporal area suggesting iris chafing as the cause. Dr. Som Prasad decided to re-explore probably with a view to cutting and removing the prodigal haptic whilst leaving the haptic and other haptic encased in the bag. At exploration the surgeon decided to try and reposition the haptic which was outside the bag into the capsular bag. A Malyugin ring is used to get good exposure, and then using two co-axial forceps the bag is re-opened. Again using bimanula maneuvers, with one forceps stabilizing the bag the other grasps the haptic and brings it back within the bag. There is some zonular weakness in the infero-temporal quadrant, and indeed the haptic is seen entangled with the remaining zonules. Careful manipulation successfully releases the haptic from zonules and reimplants it into the capsular bag, at the same time the bag is supported by another pair of forceps to minimize bag movement and limit further damage to zonules. The IOL remains centrally placed and at last follow up, six months post revision surgery, she remains asymtomatic.

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