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Matt Ward, MD, Thomas A. Oetting, MD
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In this video, Thomas A. Oetting, MD, shares an interesting case performed by third-year resident, Matt Ward, MD. When the iris prolapsed through the paracentesis just after making the paracentesis, it was attributed to IFIS. However, the surgeons soon discovered that vitreous had worked its way around the lens via weakened zonules pulling the iris with it as it egressed the paracentesis.
After performing a vitrectomy and particulate staining, the surgeons opted for an early CTR placement to center the lens, support the weak zonules, and to narrow the path for vitreous to come forward. When placing a CTR while the lens still present, viscodissecting with cohesive OVD will provide a space to position the CTR just under the capsule, thus making cortical removal less difficult.
Posted: 5/08/2012
Matt Ward, MD, Thomas A. Oetting, MD
In this video, Thomas A. Oetting, MD, shares an interesting case performed by third-year resident, Matt Ward, MD. When the iris prolapsed through the paracentesis just after making the paracentesis, it was attributed to IFIS. However, the surgeons soon discovered that vitreous had worked its way around the lens via weakened zonules pulling the iris with it as it egressed the paracentesis.
After performing a vitrectomy and particulate staining, the surgeons opted for an early CTR placement to center the lens, support the weak zonules, and to narrow the path for vitreous to come forward. When placing a CTR while the lens still present, viscodissecting with cohesive OVD will provide a space to position the CTR just under the capsule, thus making cortical removal less difficult.
Posted: 5/08/2012
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Just Now
stephen gee
11 years ago
Looks like the resident punctured through the iris because there was pigment in the clear cornea incision when he removed the blade. O/w excellent management
Boris Ovodenko
13 years ago
Great video! Ahmed CTS stabilized with iris hook in the area of zonular weakness is another alternative to CTR. The advantage of the former is ability to adjust it during cortex removal and one can leave it in a capsular bag should scleral suture fixation become necessary in the future. Boris Ovodenko
Carol Drake
13 years ago
It really looks like the initial paracentesis went full thickness through the iris. Maybe just incidental to the vitreous loss etc? Carol Drake
thomas oetting
13 years ago
drake yes alot of folks that saw this video on http://facebook.com/cataract.surgery thought the same thing. however i suppose you will just have to believe me that the paracentesis blade did not go into the iris. even if it did (which i have done before) i do not think you would get vitreous. thanks for your comment! tom o