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Robert Cionni MD
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Management of a posterior polar cataract can be challenging, especially when combined with a zonular dialysis. After making a CCC under a generous amount of OVD, Robert Cionni, MD, carefully bowls out the central portion of the nucleus. If the instruments are placed deep within the groove, only a small amount of pressure is needed to crack the nucleus in half. OVD is used to as a temporary expander during phaco when the periphery of the bag begins to collapse. After lens material is successfully removed with no capsule tears, a CTR is inserted in the bag prior to IOL injection.
Posted: 3/15/2011
Robert Cionni MD
Management of a posterior polar cataract can be challenging, especially when combined with a zonular dialysis. After making a CCC under a generous amount of OVD, Robert Cionni, MD, carefully bowls out the central portion of the nucleus. If the instruments are placed deep within the groove, only a small amount of pressure is needed to crack the nucleus in half. OVD is used to as a temporary expander during phaco when the periphery of the bag begins to collapse. After lens material is successfully removed with no capsule tears, a CTR is inserted in the bag prior to IOL injection.
Posted: 3/15/2011
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Just Now
ari weitzner
14 years ago
my suspicion is that if there is an adhesion between the opacity and the capsule, then no matter how gently the cataract is removed, the posterior capsule will be compromised. so i think the technique of removing the cataract does NOT necessarily save the posterior capsule- i think that issue is determined before the surgery starts. the gentle technique allows the surgeon to reduce the risk of dropping the nucleus.
Justo Mio
14 years ago
Beautifully done, like all your surgery videos. Why not place a 3 piece in the sulcus, with or without optic capture? These sometimes go well and 5-10 years later the retina doc has to go retrieve them.
Robert Cionni
14 years ago
This was a traumatic cataract that should not be subject to prgresive zonular loss. Please do not ever attempt sulcus fixation without sutures as there is no barrier to sunset syndrom through the missing zonules. I;ve seen it time and time again. The best place for the IOL is in the bag as long as the bag can be centered and stabilized.