cataract following IOFB with primary posterior capsulotomy скачать в хорошем качестве

cataract following IOFB with primary posterior capsulotomy

Here is an interesting case of a young patient who had a cataract following intra-ocular foreign body (IOFB) and pars plana vitrectomy (PPVx). several special issues came up including not doing hydro-dissection, performing a primary posterior capsulotomy, and the use of traditional optic capture. The IOFB entered near the limbus so we were worried about the possibility of a peripheral capsular tear which led us to avoid the use of hydro-dissection and to avoid the placement of a capsular tension ring (CTR). As the lens was soft we were able to use the irrigation aspiration hand piece for the entire nucleo-fractis and did not need to spin the lens or use hydro-dissection. The patient had a dense posterior capsular fibrosis so we opted for primary posterior capsulotomy. We used a 27 gauge needle with cohesive OVD to pierce the posterior capsule and nearly simultaneously place the OVD between the posterior capsule and the anterior hyaloid face (what was left of it following the PPVx). The OVD also pushes the posterior capsule anterior making the capsulotomy easier. the posterior capsulotomy was continuous but not centered. We used a large optic (6.5 mm) Alcon MA50 IOL in the traditional optic capture configuration with the haptics in the sulcus and the optic posterior to the anterior capsule. If we would have been able to have a more centered posterior capsular opening i might have prolapsed it behind the posterior capsule also. thank you for any comments. tom o