This patient truly needs our help. She developed a cataract in the right eye a few years ago and was unable to seek appropriate ophthalmic care until recently. She has the dense cataract that you see in the photo above, plus she has 8 prism diopters of right eye sensory exotropia. The cataract looks very dense with a brunescent color behind the white cortical spoking.
Of note, there is a prominent gap between her iris and the anterior lens capsule. When we see this gap it is often associated with zonular laxity which allows the cataract to fall towards the vitreous cavity. In this case, there is no serious zonular laxity and there is no phacodonesis. The gap is due to the absorption of the liquefied lens cortex which allows the lens capsule to contract. We present the entire surgery in this video and we encourage all newer surgeons to watch it in full (less than 8 minutes).
Click below to learn from this complete case from start to finish:
Do you ever feel like turning such a dense lens on its side Completely like that places too much posterior forces on the PC and damaged zonules? I like this technique but that’s my only hang up.
In this case, no issues with zonules or capsule. It’s all about technique. This is an advanced technique and not easy for a new
Surgeon to perform.
Seems very useful. Thanks for sharing. Ever use miloop on these types of lenses?
that video is coming up on CataractCoach.com in the near future.