Intraoperative lens sparing in a case of Behcet uveitis Masquerading as Cataract скачать в хорошем качестве

Intraoperative lens sparing in a case of Behcet uveitis Masquerading as Cataract

Description: This video presents the surgical management of a 23-year-old patient with chronic Behçet's uveitis in the right eye, presenting with a severe drop of vision to BCVA 0.1. Preoperative Findings: The anterior segment reveals significant posterior synechiae and a dense fibrinous membrane over the lens, giving it a cataractous appearance. B-scan shows a flat, attached retina. Planned Procedure:Synechiolysis, fibrinous membrane peeling, and phacoemulsification with IOL implantation. Intraoperative Course: 1. Meticulous synechiolysis is performed to mobilize the iris. 2. The fibrinous membrane is carefully grasped and peeled from the lens surface, revealing a surprising finding: a completely **clear crystalline lens**. 3. Faced with this discovery, the surgical plan is re-evaluated intraoperatively. 4. The decision is made to abort the phacoemulsification procedureto preserve the natural lens and avoid inciting further inflammation. Outcome: The surgery is concluded successfully. With postoperative medical management, the patient's inflammation settles and the best-corrected visual acuity improves dramatically to 0.7 Key Learning Points: In uveitic eyes, pre-operative "cataract" may be a fibrinous pseudomembrane. The critical importance of removing all inflammatory material before assessing lens clarity. Surgical flexibility and the ability to change plan based on intraoperative findings are essential. Preserving the crystalline lens in a young patient is a significant long-term advantage. This video demonstrates a nuanced approach to uveitis surgery, emphasizing lens preservation when possible.