Extreme subluxated lens management

• 29 May 2020
• Dr. Sourabh Patwardhan
• 412
• 0

This video is showing management of extreme case of subluxation like marfans .for the ccc- use cohesive viscoelastic. ccc is difficult due to the lack of resisitance. after the initial nick, we can use a capsulorhexis forceps. but a complete ccc is a must. after this, we put capsular hooks. while putting capsular hooks , do not tighten initially but after placing all hooks tighten slowly. hydrodissection has to be very slow and gentle. use bimannual irrigation and aspiration with lower parameters to mainatin anterior chamber stability. Before withdrawing the cannula inject visco from other side. Next put CTR . take care that the ctr does not get stuck in the capsular hooks. remove the capsular hooks. insert the capsular segment slowly. if required , enlarge the wound. make a scleral flap in the center of subluxated part. pass 9-0 prolene in central islet.pass the 26 g needle through scleral tunnel and thread the 9-0 prolene suture into 26 gauge needle and pulling it out. this will pull the bag to the side of subluxation and centralise it. ensure that the central part of ct segment is above the anterior capsule. tighten the knots and bury in scleral tunnel. the lens is then placed in the bag. For phaco fellowship and training contact patwardhan.sourabh@gmail.com.

Published By Dr. Sourabh Patwardhan

FRCS (UK), MS (AIIMS), DNB, MNAMS, FICO

Director, Nandadeep eye hospital, Sangli,India.
He heads a very popular Phaco training and fellowship program.