Search
Search
Omar Barrada, MD
Show Description +
Omar Barrada, MD, shares a case in which a tear forms in the posterior capsule during phacoemulsification of a hypermature cataract causing the entire lens to fall backwards onto the retina of a previously vitrectomized patient. After attempting to remove the dropped lens using the vitrector fails, PFC flotation of the lens anteriorly and subsequent removal is done, followed by ACIOL implantation.
Posted: 4/11/2013
Omar Barrada, MD
Omar Barrada, MD, shares a case in which a tear forms in the posterior capsule during phacoemulsification of a hypermature cataract causing the entire lens to fall backwards onto the retina of a previously vitrectomized patient. After attempting to remove the dropped lens using the vitrector fails, PFC flotation of the lens anteriorly and subsequent removal is done, followed by ACIOL implantation.
Posted: 4/11/2013
Please log in to leave a comment.
Comments
Just Now
Paolo Rossini
11 years ago
Good job. Perfect if you implant posterior iris-claw IOL, as I usually do in these cases.
Ahmed kotb
12 years ago
good job sir ...
Valerio Piccirillo
12 years ago
Usually in these cases the problem is that you can not mantain the nucleus intorno the anterior chamber as you do not have any capsular residual onto the nucleus may be' leaved on. So , To avoid the use of decaline , I engage the nucleus with the vitrectomy probe ( cut rate off ) and when the nucleus is on the pupillary plane I stabilazy it helped by a 20 g vitrectomy blade. The nucleus removal from anterior chamber will be facitated by a ecce loop !
Rodrigo Oliveira
12 years ago
In this cases I would use the phacofragmenter tip only to bring the hard nugleus to the anterior chamber, once that the vitrectomy handpiece doens't get buried inside these hard nucleus. The phacofragmenter tip can be impaled into the nucleus. This avoid the use of PFCL.
laura cozzarelli
12 years ago
Thanks for posting this - it's a great learning tool for all of us..
laura cozzarelli
12 years ago
Thanks for posting this - it's a great learning tool for all of us. Also, it looks like the sleeve on your phaco is covering a bit too much of the phaco tip. You may have had more efficient grooving/occlusion if the sleeve were further back.
ussama abdalla
12 years ago
Why not ECCE+IOL You are not a safe surgeon
ari weitzner
12 years ago
1. why not use iris hooks/malyugin when the pupil is so small in a difficult case like this? 2. why not use capsule hooks when there is subluxation in a difficult dense cataract? agree that doing ecce would have been the better idea, in hindsight. the lesson here is that in very dense lens, is to have excellent exposure-enlarge the pupil- and capsule hooks when the zonules look weak. also, in dense lens, critical to make very very deep trough until red reflex can be seen, and then i typically use a ernst nucleus cracker when makes cracking easy and stress-free to zonules. thanks for posting this humbling video!