CataractCoach™ 2451: Pseudo-Exfoliation Cataract 2nd eye скачать в хорошем качестве

CataractCoach™ 2451: Pseudo-Exfoliation Cataract 2nd eye

This patient has pseudo-exfoliation (PXF) syndrome and the first eye had cataract surgery many years ago. There is capsular phimosis of the anterior capsular rim which was treated by using the YAG laser to create relaxing cuts at the 12, 3, 6, and 9 o'clock positions at the edge of the capsulorhexis. Now it is time for cataract surgery on the second eye and the question is what should you do differently? This patient typically has a small pupil but after many doses of mydriatic agents including 10% phenylephrine, I managed to dilate the pupil to about 6 mm. Looking at the photo you can see the fibrillar material from the pseudo-exfoliation on the anterior lens capsule in a bulls-eye target pattern. The fibrillar PXF material goes everywhere in the anterior chamber but there is a zone of clearing on the anterior lens capsule where the iris edge cleaned the capsule as the pupil size changed. The remaining central PXF material shows us the normal photopic pupil size. And the outer edge of the zone of clearing shows the scotopic pupil size achieved. Clearly our pharmacologic mydriatic agents made a big improvement. Typically pseudo-exfoliation is asymmetric with one eye affected more than the other for reasons that are not entirely clear. Given this patient's history, what should we do differently for the 2nd eye cataract surgery? Please comment below.