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David Chang MD
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Dr. David Chang presents a pseudoexfoliation patient with a trampolining posterior capsule due to compromised zonules. The cortex is adherent to the capsule, making cortical clean-up difficult. Dr. Chang recommends filling the bag with a dispersive OVD to buffer and protect the bag during I/A. A Morcher pre-loaded CTR (FCI-Ophthalmics, Marshfield Hills, MA) is inserted to prevent capsular contraction syndrome prior to placing a 3-piece foldable IOL into the sulcus.
Posted: 3/30/2010
David Chang MD
Dr. David Chang presents a pseudoexfoliation patient with a trampolining posterior capsule due to compromised zonules. The cortex is adherent to the capsule, making cortical clean-up difficult. Dr. Chang recommends filling the bag with a dispersive OVD to buffer and protect the bag during I/A. A Morcher pre-loaded CTR (FCI-Ophthalmics, Marshfield Hills, MA) is inserted to prevent capsular contraction syndrome prior to placing a 3-piece foldable IOL into the sulcus.
Posted: 3/30/2010
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Comments
Just Now
Justo Mio
15 years ago
What about trying Dewey's J-Cannula? Then you are not pulling on the zonules, but keeping the bag inflated.
Bryan Angle
15 years ago
Additionally, Using the silcone IA tip to remove the cortex is helpful. It has a much smaller opening in thr tip which will allow better purchase on the cortex and less chance of capture of the loose capsular bag. Bryan Angle, MD
Jay Novetsky
15 years ago
David, an alternative approach is to inject any type of viscoelastic followed by the IOL and THEN perform the I/A when the post capsule is protected and held taught by the haptic and optic. Jay Novetsky, M.D.