The aim of the study was to demonstrate a successful repair of Descemet membrane detachment (DMD). A 73-year-old woman with pseudoexfoliative glaucoma underwent phacoemulsification with flexible posterior chamber intraocular lens implantation. Because of inadequate pupillary dilatation flexible iris retractors were used. Four days after cataract surgery, a large DMD was recognized. One day later, the patient underwent surgical repair. Three long full-thickness 10-0 nylon sutures were used to fixate DM to the cornea. The next day, DM was completely attached and the cornea was clear. Final best-corrected visual acuity was 0.9. Iris retractors may increase the risk of DMD because the iris is more anterior to the cornea. Bimanual manipulation is recommended to avoid accidental separation. No clinical case of DMD repair has been previously reported, associated with flexible iris retractors and phacoemulsification. To achieve good visual results in extensive DMD we recommend early surgical treatment.
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Am J Ophthalmol Case Rep
December 2024
Capital Health, Trenton, NJ, USA.
Optic capture of a three-piece lens in the absence of posterior capsule support is an effective strategy for stabilizing and sequestering the optic to reduce the risk of dislocation and UGH syndrome compared to sulcus placement. We present a novel technique that facilitates optic capture in the presence of a contracted, fibrotic rhexis opening, while minimizing stress on the zonules by using iris retractors to assist in stabilization and expansion of the rhexis, followed by direct injection of the optic of the lens behind the anterior capsule opening into an optic captured configuration.
View Article and Find Full Text PDFAm J Ophthalmol Case Rep
June 2024
Deparment of Pathology and Surgery, Miguel Hernández University, Elche, Alicante, Spain.
Purpose: To describe the use of FLACS (Femtosecond-Laser-Assisted Cataract Surgery) and pupiloplasty technique employed in a cataract surgery associated with iris-lens-zonule coloboma, as well as to report the advantages that FLACS can provide in this type of complicated surgery.
Observations: During FLACS (Victus® - TECHNOLAS, Bausch and Lomb Incorporated, USA), after the docking procedure, the parameters of capsulotomy, fragmentation and incisions were manually adjusted. Iris retractors were anchored to the edge of the anterior lens capsule to provide stability to the bag during phacoemulsification maneuvers, and a capsular tension ring and intraocular lens (IOL) were implanted.
Indian J Ophthalmol
July 2024
Sankara Eye Hospital, Pedakakani, Guntur, Andhra Pradesh, India.
Purpose: To study the outcomes of phacoemulsification in small pupils (≤4 mm) using pupil expansion devices at a tertiary eye care center in South India.
Methods: The study design is prospective, randomized, comparative, and interventional. Mechanical pupil dilatation with iris retractors (group I), B-HEX ring (group II), and Gupta ring (group III) was compared with respect to pupil size achieved (intraoperative), total surgical time, device addition time, complications, endothelial cell loss, and postoperative best corrected visual acuity.
Indian J Ophthalmol
May 2023
Department of Phaco and Refractive, Nethradhama Superspeciality Eye Hospital, Bangalore, India.
Insufficient pupillary dilatation is a significant challenge during cataract surgery, as it increases the risk of various intraoperative complications. Implantation of toric intraocular lenses (TIOL) is particularly difficult in eyes with small pupils, as the toric marks are provided in the periphery of the IOL optic, making the visualization of the same difficult for proper alignment. Attempts at visualizing these marks using a second instrument such as a dialler or iris retractor lead to additional manipulations in the anterior chamber resulting in increased chances of postoperative inflammation and intraocular pressure rise.
View Article and Find Full Text PDFJ Int Med Res
September 2022
Ocular Trauma and Emergency Department, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
We describe a technique for metallic intralenticular foreign body (ILFB) removal in a patient in whom there was no or minimal cataract formation or other complications. This technique required creating two corneal small incisions around the ILFB for inserting iris retractors to expose the ILFB. At the foreign body position, a clear corneal incision was made, and then the ILFB was removed with minimal manipulation by an intraocular magnet without complications.
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