Dr. D. D. Verma MD (AIIMS)Dee D Eye InstituteIndia Phacoemulsification in a specific traumatic cataract case (Author does not have any financial interest)
Purpose In traumatic cataract , with an anterior capsular tear, phaco involves the risk of extending the tear with chances of lens matter falling in vitreous cavity. we devised a new technique for successful phaco with foldable IOL implantation in this particular case.
Capsule Tear Capsulorhexis
Method We advised the patient to wait for 15 days before surgery could be done, as we wanted the margins of the capsular tear to get fibrosed. During surgery,a new opening in ant capsule was made separately from the existing defect, which left a gap of bridging capsular tissue between these two openings. Phaco was done using low parameters to avoid surge & turbulence in the ant chamber & capsular bag. The lens matter in the adjoining area of the preexisting defect was taken out bimanually after implanting the IOL
Result Phaco with IOL implantation could be done successfully without the risk of extending the already existing defect in anterior capsule.
Conclusion First waiting for 15 days to let the margins of the capsular tear to get fibrosed, & then during surgery,making a separate opening in anterior casule away from the already existing defect in ant cap due to trauma & doing phacoemulsification using low flow & vaccum, using bimanual IA, increases the chances of successful phaco with lens implantation in such cases.