This video demonstrates IOL implantation techniques in a few challenging cases. Dr. Masket explains all the steps in detail while implanting the lenses and dealing with the challenges.
In the first surgery, a posterior capsular rent was managed and an IOL was placed in the sulcus. The patient was then referred to the vitreoretinal surgeon for the management of the retained intravitreal nucleus.
The second patient had pseudoexfoliation and diffused zonulysis. The phacoemulsification was performed after placing the capsular support hooks. A Henderson modified capsular tension ring was used and a single piece acrylic lens implanted in the capsular bag.
The third patient had a progressive zonulopathy, years after an IOL was inserted in the capsular bag. The IOL along with the capsular bag complex was centered by fixating it to the sclera using sutures.
In the fourth patient, the IOL was improperly placed with the inferior optic in front of the bag, inducing marked damage to the inferior iris and repeated microhyphema. The IOL was repositioned in the bag and therefore preventing any further iris damage.
The fifth patient had a significantly-subluxated PC IOL after a complicated cataract surgery. The IOL was explanted and a 6mm, 3-piece acrylic lens was placed and secured to the iris using sutures.
The sixth patient presented with a lens-induced Z-Syndrome. The IOL was explanted and a 3-piece Collamer IOL was placed inside the capsular bag.
Surgeon: Samuel Masket MD, Advanced Vision Care, David Geffen School of Medicine, UCLA, USA
February 21, 2018