CataractCoach™1713: pars plana tap for aqueous misdirection скачать в хорошем качестве

CataractCoach™1713: pars plana tap for aqueous misdirection

The key to resolving iris prolapse is to release the pressure gradient and we have covered this topic many times before. Usually there is fluid trapped behind the nucleus and in front of the posterior capsule, so rocking the nucleus can resolve the iris prolapse in just a second or two. However if the fluid goes through a zonular gap and is now stuck behind the posterior capsule and in front of the anterior hyaloid face, we have a different challenge. This misdirection of aqueous (or balanced salt solution) creates a strong pressure gradient which will push the iris out of the incision. The solution is to remove this fluid and in this video it is done with a pars plana tap. An empty syringe (3cc or 5cc is fine) with a 25 or 27g needle is placed through the pars plana and suction is applied to remove this misdirected fluid. This resolves the gradient, deepens the anterior chamber, and the case can proceed smoothly. This is truly a great video, so much so that I have temporarily suspended our rule of "only HD videos" to show you this technique.