A moderately dense nuclear cataract is removed by phacoemulsification, utilizing techniques that minimize stress on the lens zonule.
A post-traumatic pupil deformation has caused disabling glare. Two months after complex
cataract-IOL surgery with suturing of a capsular tension ring to the sclera and toric IOL insertion, the pupil is
repaired (sutured iridoplasty).
Blunt trauma has caused a subluxated cataract with vitreous
prolapse. Phacoemulsification with insertion of 2 capsule tension rings, one of them sutured to the sclera, are demonstrated.
After routine phacoemulsification and IOL insertion, a spontaneous opening in the posterior capsule is observed without obvious cause. A small capsulorhexis must then be enlarged to permit reverse capture of the optic of the single piece, trifocal IOL.
A patient with glaucoma and previous LASIK undergoes implantation of recently modified trabecular microstents after cataract extraction with IOL implantation. Stent implantation technique, post-refractive surgery IOL calculation methods, and persistent leakage from the clear corneal incision caused by the “flipped lip syndrome” are demonstrated and discussed.
Phacoemulsification of a mature, white cataract is performed. The morphology of the anterior capsule (flat vs convex) and its impact on the capsulorhexis procedure are discussed.
Methods to reduce endothelial trauma, deal with a floppy iris, and determine IOL power in a keratoconic eye with a shallow chamber and floppy iris are presented.
Phacoaspiration is performed in a 40 year-old patient. Obtaining an intact capsulorhexis was more difficult because of pre-existing subcapsular fibrosis.
Here we depart from our usual presentation of intraocular microsurgical procedures and techniques . A very elderly patient with early phthisis bulbi, and a blind and extremely painful eye receives a retrobulbar alcohol injection to immediately relieve her intractable pain. The appropriate alcohol concentration and anticipated outcome is also discussed.
Two weeks after uneventful cataract – implant surgery, an IOL exchange is performed in a keratoconic eye because of a refractive surprise.