Phacomorphic Glaucoma with a very Shallow anterior Chamber-Phacoemusification-Dr Deepak Megur скачать в хорошем качестве

Phacomorphic Glaucoma with a very Shallow anterior Chamber-Phacoemusification-Dr Deepak Megur

This video highlights the challenges and possible solutions when dealing with a case of Phacomorphic Glaucoma with a swollen intumuscent lens and a very shallow anterior chamber. Before surgery IV mannitol was given. The surgery is begun under topical anesthesia with intra cameral lignocaine. A two staged rhexis has been planned. Creating the primary rhexis itself is a task here. I am using the tearing technique predominantly i.e i am keeping the flap flat and then tearing it in a centripetal direction to prevent the rhexis from straying away towards the equator. After creating a small primary 3mm CCC , i am decompressing the bag using a 23 G cannula which comes handy to aspirate the thick swollen lens matter. I find this more efficient than the small bores of the Irrigation aspiration cannula. Then further decompression is achieved by passive irrigation of the capsular bag , but care needs to be taken to press on the posterior lip of the main incision so that the intra bag pressure is not raised. Once the Lens matter surrounding the anterior and the posterior aspect of the nucleus is removed , now is the time to do the secondary largere rhexis. After a tangential cut with a micro forceps, the rhexis is enlarged to about 5 mm with a forceps.