Abstract
Some cataract surgeons still stand by their claim that if a piece of the lens is lost into the vitreous during lens removal, it is acceptable to “fish” for it. Of course, the complications arising from such maneuvers are seen and treated by the VR surgeon, who must in turn be aware of the technical issues, risks, and preventive measures to deal with this normal complication of cataract surgery, although the timing of vitrectomy is somewhat controversial. If an IOL is dislocated, removal is not urgent, and there are different options for the reconstructive surgery.
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Notes
- 1.
A lens that is subluxated due to trauma is discussed under Sect. 63.6.
- 2.
See Sect. 38.6 if an iris-claw IOL has luxated.
- 3.
The one that is closer to 12 o’clock in the patient’s eye.
- 4.
An even better solution would be an endocryo probe, but this is not available in MIVS.
- 5.
If you have a forceps (Sunderland-type; Grieshaber, Schaffhausen, Switzerland) that can be easily rotated with your finger without you having to rotate your hand, you can directly grab the distal haptic, and turn the rotating dial 180° so that the IOL is above the forceps.
- 6.
Because it is damaged; it is the wrong type of IOL to be placed in the sulcus; there is insufficient capsular support etc.
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Kuhn, F. (2016). Dropped Nucleus and Dislocated IOL. In: Vitreoretinal Surgery: Strategies and Tactics. Springer, Cham. https://doi.org/10.1007/978-3-319-19479-0_44
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DOI: https://doi.org/10.1007/978-3-319-19479-0_44
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