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Iatrogenic Zonular Disaster

  Channels: Cataract Surgery | Posted 2/17/2010

In any eye with suspected weak zonules, it is in the surgeon’s best interest to create the largest feasible rhexis and chop the nucleus into small pieces. The failure to chop the nucleus into small pieces led to the iatrogenic disaster of 180º zonulolysis. In challenging and complicated cases such as zonular dehiscence or posterior capsular rupture, Dr. Khiun Tjia, MD, prefers to use very low fluidics with torsional ultrasound. With an adequate visco-shield in place, the nucleus can be safely emulsified in the anterior chamber. The elderly woman decided to remain aphakic as a +4.00 D hyperope, with excellent television and reading vision.

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