Subluxated cataract : decision making- SICS with CTR and CTS

• 29 May 2020
• Dr. Sourabh Patwardhan
• 488
• 1

I will be talking about decision making in a subluxated cataract. The challanges in this case are dense cataract, fibrosed capsule and 6 clock hours subluxation. plana - phaco/sics with CTR and CTS and lens in bag. Plan B is doing is do SICS and anterior vitrectomy with ACIOL/ Iris claw or SFIOL. CCC is the main deciding factor. I stained the anterior capsule and started CCC. As there was fibrosis, i had to make a nick and complete the hexxis from other hand. if there is no fibrosis, you can use sinskey in other hand to support. as i am not sure of integrity of CCC in fibrosed area so i use SICS . I used capsular hooks to support subluxated capsule. I made a tunnel, and do hydrodissection .use 2 sinskey to prolapse nucleus from bag. viscoexpression to deliver nucleus. take care not to cause anterior chamber collapse or distension at any time. after this i put CTR . I keep a thread in CTR to be safe. i judge the posterior capsule and CCC integity which is good. as there is 6 clock hours subluxation so i have to fix the bag to sclera. So i put CTS , i thread the central islet . Take care to put peripheral islets in the bag and central islet infront of capsule. i make a scleral pocket in the area of subluxation. then i make a clear corneal incision opposite it to pass my needles. using the rail roading technique , i fix the the segment and tighten the knot below the scleral flap. 9-0 prolene suture is used. then i place the non foldable iol in the bag. the haptics lie in area of subluxation. visco is washed.

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.