This video shows a very important lesson that all beginning surgeons must learn. A lack of pivoting in the incision ends up gaping the incision. Then the cohesive viscoelastic burps out of the incision in a big clump, resulting in a shallow anterior chamber. This leads to a collapsed capsular bag and then the resident surgeon inadvertently places the trailing IOL haptic into the sulcus. And we know that this is a recipe for problems like UGH syndrome: uveitis, glaucoma, hyphema as the thick haptic scrapes the posterior aspect of the iris.
We have previously shown a video of this problem which we luckily caught on post-op day 1. We repositioned the IOL on that first post-op day and made sure that the entire IOL and both haptics were securely placed into the capsular bag. And the patient did well with an excellent visual outcome.
This video shows a resident case where the pupil was moderately dilated so it was not obvious to this young surgeon that the trailing haptic was sitting in the ciliary sulcus. Fortunately, the attending surgeon helped out and placed the IOL fully into the capsular bag. Remember, you absolutely must pivot in your incisions to avoid wound gape!
click to learn from this important lesson so you can avoid this problem in the future: