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Priya Narang, MS
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The video depicts the case of a 54-year-old woman who presented with a history of cataract surgery preformed 4 years back. On examination, she had a subluxated capsular bag IOL complex with endocapsular ring and a dislocated segment and a 3 -piece IOL in the bag. A decision was taken to fix up the same IOL with glued IOL technique. This obviated the need to enlarge the incision and facilitated a closed chamber procedure but with its due set of challenges. These cases need a very good pre-operative assessment, a lot of intra operative surgical care, and multiple contingency plans.
Posted: 6/20/2014
Priya Narang, MS
The video depicts the case of a 54-year-old woman who presented with a history of cataract surgery preformed 4 years back. On examination, she had a subluxated capsular bag IOL complex with endocapsular ring and a dislocated segment and a 3 -piece IOL in the bag. A decision was taken to fix up the same IOL with glued IOL technique. This obviated the need to enlarge the incision and facilitated a closed chamber procedure but with its due set of challenges. These cases need a very good pre-operative assessment, a lot of intra operative surgical care, and multiple contingency plans.
Posted: 6/20/2014
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Just Now
Martin Pillichshammer
10 years ago
Thank You, nice surgery is`nt it that way, that the OCT shows a plane/convex optic
Zia Mazhry
11 years ago
There is no doubt you handled the situation proficiently. Fibrin glue is of course a wonderful tool. The real trick is haptic externalization through pars plicata. I am just exploring and looking forwards to more atraumatic haptic externalization approach.
Zia Mazhry
11 years ago
Dislocation into vitreous cavity and thus PPV may have been avoided if IOL bag complex had been grabbed and ateriorized before Anterior vitrectomy. Have a look on the following link, the case is simpler but definitely similar. http://eyetube.net/?v=epaso
Dr. Priya Narang
11 years ago
I do agree that the drop of bag-IOL complex could have been avoided if I had not abruptly come out of the eye after trying to clear the adhesions around the complex. But as shown in the video, there is already a complication occurring due to degradation of 10-0 suture (Endocapsular segment dislocation in to anterior chamber). Again using a 10-0 suture as shown in your video is not a feasible procedure according to me. If at all it is to be done then a 9-0 suture can be used or a Gortex suture. I did not intend to fix the bag with a suture as it was already a complicated eye; instead I cleared the adhesions and fixed up the IOL with Glued Technique. The surgeon should be ready with contingency plans while handling such cases.
Zia Mazhry
11 years ago
Thank you for depicting this meticulous technique. I have uploaded an insitu IOL bag complex rescue and fixation technique. Please have a look on the following link: http://eyetube.net/?v=epaso
BOGDAN-ION CUCU
11 years ago
great surgery
Jason Jones
11 years ago
very nice surgery. the IOL appears inverted at the end; i take it no issues?
Dr. Priya Narang
11 years ago
That's very observant and yes you are right that the IOL is inverted as during externalisation it came like that. It is a bi-convex lens so no issue on it . Patient post op was 20/20. Thank you.
Esin Erbilen
11 years ago
great surgery!thank you
Dr. Priya Narang
11 years ago
Thank you so much
Jung Won Park
11 years ago
Beautiful surgery!
ari weitzner
11 years ago
whew! what a case.
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