Embed Size (px)
Citation preview
Eye Care & Management
Insights for better sight.
Dr Nitin Prabhudesai
Management of Dropped Nucleus & IOL
Dr Nitin Prabhudesai
Why the Nucleus Drop Occurs?
• Rent in the Posterior Capsule– Surgical Trauma– Pre existing traumatic defect,
Needle touch– Polar cataract
• Extension of Capsulorhexis • Zonular dehiscence• Pseudoexfoliation
Dr Nitin Prabhudesai
Why the IOL Drop Occurs
Dr Nitin Prabhudesai
When to Remove Dropped Nucleus
Dr Nitin Prabhudesai
• Ideally any amount of dropped nucleus should be removed
• Most Nuclear fragments incite an inflammatory reaction & rise in IOP
• No attempt to “Fish Out’’ the nucleus hastily
• Anterior Vitrectomy with closure of wound
Should IOL be placed ?
• If the Anterior Capsular rim is intact IOL can be placed
• If Capsular support not adequate – Anterior chamber IOL– Iris claw IOL
Dr Nitin Prabhudesai
• Visual disturbances• Retinal defects
When to remove Dropped IOL
Dr Nitin Prabhudesai
How to remove Nuclear Fragments
• 3 port Vitrectomy• Fragmatome for larger & harder cases• PFCL use to float the Nucleus• Vitrectomy Cutter for softer cases• Placement of IOL• Secondary IOL
Dr Nitin Prabhudesai
Secondary IOL
• Choice of Secondary IOL after Primary surgery– IOL on capsular rim– Scleral Fixated IOL– Glued IOL
Dr Nitin Prabhudesai
IOL removal
• 3 port Vitrectomy• IOL removal• Placement of secondary
IOL
Dr Nitin Prabhudesai
Dropped Nucleus
Presentation Video
Dr Nitin Prabhudesai
Dr Nitin Prabhudesai
Vitrectomy IOL Removal
Presentation Video
Dr Nitin Prabhudesai
Dr Nitin Prabhudesai
IOL Removal
Presentation Video
Dr Nitin Prabhudesai
Dr Nitin Prabhudesai
Thank you
Dr Nitin Prabhudesai
