2950: Quiz: Why sudden miosis and AC shallowing?
It’s time for another CataractQuiz™, and this one features a critical teaching moment from an anonymous resident surgeon. In this case, we see a sudden, unexpected miosis and shallowing of the anterior chamber right after the main incision is created. Why did this happen, and why is that keratome blade pushed so incredibly deep into the eye? The hint tells the whole story: the surgeon advanced the side-port blade too far, inadvertently puncturing the anterior lens capsule. This decompression of the anterior chamber combined with direct mechanical trauma to the lens splits the capsule wide open and then the loss of aqueous causes the sudden miosis. The damage is revealed when Trypan blue dye is instilled into the eye and then there is a further surprise when the vitreous has been stained blue as well. Watch this video to see the full analysis of this surgical misstep and learn how to avoid these problems.
