We have a great learning case from Dr. Xiaogang Wang from Taiyuan, China with a surgical challenge. This patient has a traumatic white cataract and a history of damage to intra-ocular structures including angle recession and zonular weakness/loss. The challenge happens when the technician does not prime the I/A hand-piece and a large air bubble is introduced into the anterior chamber. The continued infusion pressure causes this large air bubble to go through an area of zonular weakness and into the vitreous cavity. Now it is trapped. What is your next move?
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Amazing! I hope to never see this in my cases. Diligently flushing the lines now.
Lot of learning here at CataractCoach!
The air bubble will leave vitreous to AC and will absorbed spontaneously.
I experienced this a few times in eyes with prior PPV or compromised zonules. I simply equilibrate the two chambers by leaving intracameral air as I often do in my goniotomy cases compromised by angle bleeding. The air is gone in 48*
Thanks. Pars plana vitrous tap reduce vitrous pressure even if not be able to remove the bubble.