posterior polar cataract with toric IOL in the capsular bag - Uday Devgan MD Los Angeles скачать в хорошем качестве

posterior polar cataract with toric IOL in the capsular bag - Uday Devgan MD Los Angeles

This patient is one of the few with a posterior polar cataract. This means that the capsular bag can be weak, fragile, or even absent at the site of this opacity which can lead to capsule rupture, vitreous loss, nucleus displacement, and poor visual results. We can address this by doing the technique of hydro-delineation while avoiding hydro-dissection, and then using our viscoelastic to perform visco-dissection. The key is to avoid any sort of stress on the capsule. At the end of cataract removal, notice that the capsular bag is inflated with viscoelastic and the anterior chamber of the eye is not allowed to collapse. This is important to prevent capsule rupture. Finally, the toric IOL is placed in the capsular bag but then must be rotated to the appropriate axis without trauma to the posterior capsule. This can be done by using irrigation in the right hand to keep the capsule inflated while the left hand uses the Devgan Chopper Multi-tool to rotate the IOL into the optimal position. At the end of the case triamcinolone is injected (the white particles) to decrease inflammation, ensure that no vitreous or retained viscoelastic is present, and to check for incision leakage. The patient is already seeing amazingly well and we have scheduled her second eye in the near future. More information at www.DevganEye.com Uday Devgan, MD, FACS, FRCS