After DSAEK, a hydrophilic acrylic IOL develops calcification that requires an IOL exchange
Episode 71: A 16 Year Old Patient with Retinitis Pigmentosa and Dense Posterior Subcapsular Cataract.
The desired refractive outcome in this patient is the major subject of this video. Consideration of the functional visual field is extremely important, and a postoperative refraction that produces significant improvement in the patient’s field of vision is recommended.
A highly myopic patient requires deep sedation in order to overcome an extremely forceful Bell’s phenomenon. Methods to deal with this problem while maximizing the safety of the procedure in such patients are presented.
An extremely myopic eye with an increased anterior chamber depth that reduces visibility of the nucleus receives an intravitreal injection to overcome the problem.
A complex procedure is performed, including pars plana vitrectomy, manual aspiration of residual lens cortex, and elevation and removal of a dislocated IOL from the vitreous cavity. The case successfully concludes with insertion of a 3-piece IOL into the ciliary sulcus.
A small posterior capsule opening is converted to a posterior capsulorhexis in an eye with pseudoexfoliation, lax zonule and infusion misdirection syndrome.
During cataract extraction on an eye with pseudoexfoliation, a poorly dilating pupil, glaucoma and astigmatism, the nasal region of the zonule suddenly fails, enabling vitreous to prolapse through the zonule deshiscence. The use of capsule retractors, a sulcus fixated IOL with optic capture, 2 trabecular microstents and a pair of limbal relaxing incisions are demonstrated during this complex procedure.
A patient with a potentially problematic degree of corneal coma undergoes cataract–implant surgery with insertion of a diffractive multifocal IOL. Strategies to reduce possible postoperative glare/halo are presented and discussed.
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).