management of iris prolapse during cataract surgery / phaco
techniques to manage iris prolapse during cataract surgery / Phacoemulsification. The bottom line is to equalize any pressure gradients.
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there are 2 kinds of high iop post hydrodissection- 1. where the bss is trapped in the bag- nucleus comes forward, cured by rocking the ncleus, 2. bss in ant vit, the whole iris/capsule diaphragm comes forward, cured by letting viscoat out of the ac (as in this case- the rocking is not curing the problem- its the release of ovd)
in this case the nucleus is too large and bulky to be able to pop-out through a 5mm rhexis. and fourthly if the lens would pop out of the bag then such IOP rise would not occur !!!!
the BSS in this case is certainly trapped between the nucleus and the posterior capsule because when tip of the hydrodissection cannula is underneath the edge of anterior capsule how the bss can go into vitreous without rupturing the post. capsule? and secondly if it were in anterior vitreous, would it come back on rocking the nucleus with the cannula tip? it won’t !!! and thirdly the nucleus would pop out of the bag if the rhexis would have been slightly larger,
check out eyetube- the surgeon has better explanation- the bss is in the anterior vit, not behind the lens in the capsule. thats why the entire iris-lens diaphragm is pushing forward. if the bss is behind the lens in the capsule, one would see the lens popping out of the bag, which we don’t see in these cases.
great video!
The airbubble is not under the lens, it is in front of it, in the anterior chamber. It will spontaneously disappear in a few hours.
excellent. I saw the same case recently, my boss sufferring from iris prolapse after hydrodissection, after all of meaningless trial, he performed iridectomy, but even that would not work. while pahcoemulsification, PC rupture happened, he could not explain when it happened, but I was certain that the same phenomenon discribed here happened.
where is the prollapse??
Thats really interesting, although make me feel a little ill. I suffered an impact injury to my eye in April of this year and following surgery to relieve the pressure and to try to clear the blood from my eye I suffered a prolapsed iris. I had to have another operation to correct this, and will probably have to have further surgery next year to try to recover some sight.
I had cararact surgery 12 days ago and my doctor said the iris “kept popping out” I assume the above happened. I have since had a fluid movement in the periphial vision, similar to a contact lense rising up and down with blinking. Is still normal? Or just part of the healing process?
thats amazing but i hope to god i never need that op :-S
Ninguna burbuja ,solo es viscoelastico, It’s Archimedes principle only!!!
Great explaining! Thanks!
omg that is amazing and why did you/the person operating leave and airbubble under the lens? during the new lens insertion?
too good!!!!!!!!