3028: dense asteroid hyalosis
Encountering extremely dense asteroid hyalosis during cataract surgery raises an important clinical question: should we perform a concurrent pars plana vitrectomy? While asteroid bodies are typically asymptomatic and rarely degrade target visual acuity on their own, severely packed calcium-lipid deposits can significantly obscure the retroillumination during phacoemulsification and block clear views of the fundus postoperatively. Furthermore, selecting the optimal IOL material is critical, as silicone optics are prone to dystrophic calcification on the posterior lens surface in eyes with asteroid hyalosis, making hydrophobic acrylic lenses the preferred choice. Watch to see how the surgical team navigates visualization during nuclear disassembly, cortex removal, and IOL insertion. How do you approach surgical decision-making and IOL selection when faced with dense asteroid hyalosis? Should this patient also get a pars plana vitrectomy? Please comment your thoughts below.
