PFC Flotation of a Dropped Mature Cataract

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

Keywords:

Cataract

PFC Flotation of a Dropped Mature Cataract

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

Keywords:

Cataract

Please log in to leave a comment.

Comments

Paolo Rossini

11 years ago

Good job. Perfect if you implant posterior iris-claw IOL, as I usually do in these cases.

Ahmed kotb

11 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!