anterior segment total reconstruction

This is a very complex case of a patient who had cataract surgery elsewhere and sustained complications during the procedure. An attempt at Yamane IOL fixation was made but the IOL was left dangling when the haptic dislocated from the optic and caused focal scleral thinning and leakage. The iris also sustained injury and the cornea was decompensating. The patient was referred to Steve Safran MD from New Jersey, USA who performed this total anterior segment reconstruction.

Multiple procedures were performed in a single sitting: pars plana vitrectomy, IOL removal, Yamane IOL fixation, pupilloplasty, DSAEK, and even a scleral patch graft. We have edited the video and sped it up to 2x so that you can enjoy watching the highlights in just a few minutes.

The post-op result was great, with the patient achieving 20/30 vision after 2 weeks.

You do not need to be able to perform a case like this — let me tell you that I don’t. I was not trained in vitreo-retinal surgery and I therefore tend to leave pars plana vitrectomy to my retinal colleagues. Similarly, you can enjoy this video and decide that you would rather refer these rare cases to other surgeons in your community.

click to watch a total anterior segment reconstruction being performed: