Cataract surgery and congenital iris coloboma repair - Single-pass four-throw pupilloplasty See more
This is a case of congenital iris coloboma and large chorioretinal coloboma. The patient developed a +2 cataract and experienced drop in her vision(55yrs, single eye, iris + lens coloboma, about 2 clock hours of zonular dehiscence, large chorioretinal coloboma, Biometry +32, other eye has early phthisis).
Combined cataract surgery & Iris coloboma repair (using Single-pass four-throw pupilloplasty using 10/0 prolene) was performed to avoid the prismatic effect of the lens edge. I prefer to do an initial gentle stretch of the iris tissue to assess the gap + to take good bites in the iris tissue to avoid cheese-wiring (in these cases there is a gap in the iris tissue, and any repair will require some amount of iris stretch). When possible, try to preserve the geometric centre of the pupil.
Toric lens implants for patients with corneal astigmatism See more
Toric lenses are suitable for patients with corneal astigmatism. Astigmatism is a condition when the cornea, the front part of the eye, is like a rugby ball rather than a sphere. Toric lenses can correct astigmatism in the prescription. When a patient has a significant degree of astigmatism, a toric lens would be beneficial to help spectacle independence.
These lenses have special marks at the axis of the astigmatism.
They require careful pre-operative planning of the level of the astigmatism. They are inserted inside the eye after careful marking of the astigmatism meridian on the cornea and the lens is aligned along this desired meridian.
Cataract series: Hard White Cataract after antiVEGF Treatment See more
This patient quickly developed a dense cataract after intravitreal treatment. Preoperatively, it was thought that he may have a posterior capsule tear. The lens was quite swollen "intumescent" and hard.
Capsulorrhexis was carefully designed to avoid the risk of extension as the lens was intumescent. The horizontal chop technique is quite useful in the management of these cases. - Throughout the surgery, special attention not to put any pressure on the posterior capsule. Interestingly, the capsule was intact, and the possible explanation was that the intravitreal needle may have only hit, but did not break the capsule. The patient had an excellent outcome after the surgery.
