The IOL Trap technique in eyes with generalised zonular weakness due to pseudoexfoliation- Dr Megur скачать в хорошем качестве

The IOL Trap technique in eyes with generalised zonular weakness due to pseudoexfoliation- Dr Megur

This video highlights the principles of "The IOL Trap Technique" in eyes with generalized zonular weakness secondary to pseudoexfoliation. Performing phacoemulsification itself is a challenge in such eyes. The first goal is to save the capsular bag. Here are my top tips for it. 1) Ensure good visualization- Pupillary expansion devices are beneficial in such situations. I prefer B Hex ring in most situations but occasionally do use hooks as well especially when i would want to stabilize the bag as well 2) Perfectly sized and centered rhexis is critical to perform optic capture of the multipiece IOL 3)Efficient Hydrodissection 4) Early CTR insertion to stabilize the bag 5) Nucleus emulsification using a technique which the surgeon prefers the most but with utmost caution and control to ensure minimal stress on the zonules. 6) Cortex aspiration is tricky in such eyes and paramount of patience and caution is needed to gently strip out the cortex using the tangential stripping technique and visco dissection. 7) Implanting the haptics of the Hydrophobic Multipiece IOL in sulcus and after aspiration of the ovd from the bag nudging the optic posteriorly so that it gets trapped behind the rhexis margin. Principles of IOL trap Techniaque: The CTR is placed in the bag. The CTR provides equatorial expansion and 360 degrees support to the capsular bag, The haptics of the IOL placed in the sulcus with optic pushed back posteriorly to achieve the optic capture. The haptics and the optic of the lens are in 2 different planes resulting in re distribution of weight and the forces acting around the bag. The anterior pull of the haptics might compensate for the posterior pull by the capsular bag. This could potentially result in better longterm stability and centration of the lenses in eyes with moderate degree of generalized zonular weakness in eyes with pseudoexfoliation.