First Author: O.Agrawal INDIA
Co Author(s):
Purpose:
Cataracts with posterior capsular plaque and posterior sub capsular fibrous thickening are the challenging cases for all cataract surgeons. This surgical video demonstrate beautiful management of these cases.
Setting:
Rohit Eye Hospital and Child Care Centre, Indore, India
Methods:
: -management of posterior capsular plaque and posterior sub capsular fibrous thickening are done in 3 different ways depending upon the type of capsular opacity.
1, Coaxial irrigation and aspiration hand piece used with regular setting (as used for cortical removal ) for fibers attached under anterior capsule as well as on posterior capsule. Posterior capsule is polished in such a way that every time IA hand piece kisses posterior capsule and removes fibers.
2,Hydro and mechanical separation of fibrous plaque and lens fibers done with the help of hydro cannula as well as fine iris spatula
3,mechanical peeling and debulcking of fibrous plaque opacity done with the help of capsulorrhexis forceps.
Results:
With the help of microscope incorporated with red reflex enhancement facility, one or more of the above mentioned method gives us excellent results. All above methods require fine surgical skills with highest level of patience. An immediate postoperative result shows better quality as well as quantity of vision. In this era of premium IOL practice like multifocal and accommodative IOL even a bit of pco compromises the optimum results. A long term post operative result shows significantly reduced number of yag capsulotomy procedures.
Conclusions:
In many cases where postoperative capsulotomy is contra indicated all above techniques are very useful. Complicated cataracts, high myopes,post r k and post Lasik surgery cataracts require intra operative management of capsular opacities. In last few years intra operative management of capsular opacity is gaining popularity due to increased usage of premium IOLs. FINANCIAL DISCLOSURE?: No
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