1711: severe PXF and zonulopathy

This is a very challenging surgery and most surgeons would rate it a 9 or 10 out of 10 in terms of difficulty. And let me tell you that this video is going to make other experts leave comments with alternatives that they would have pursued in the surgical judgment decision tree. In fact, I would choose a different method of IOL placement in this eye. And that is normal since we each have our own preferences and techniques, understanding that there is not just one way to approach any given case. Our guest surgeon, Guillermo Amescua MD from Bascom Palmer Eye Institute in Miami, is a true expert in difficult cataract cases and I have admired his work for many years. He does a fantastic job with this tough case… but what would you do differently? Leave a comment below.

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  1. would do what you suggested. 3 piece iol with optic capture. ctr after cat removed and the 2 capsule hooks removed (remove before ctr placed or may catch the ctr). Over time, wouldn’t be surprised if the entire
    bag complex and sulcus iol end up in vitreous/retina with further zonular compromise. If pt has sxs of this occurring before total bag drop…may be salvageable with sutures Ahmed segment

  2. Excellent case. I like to do iris hooks then replace them with capsule hooks after rhexis, then like you said put the 3 piece in the sulcus with optic capture.

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