Cataract - Special Cases Rs 500

A New Inverse Technique for Cionni Ring Implantation

Author by: Dr. Pravin Vaddavalli Krishna
Year of Publication: 2005

Subluxated cataracts have been traditionally managed with the implantation of a capsular tension ring, also called an endocapsular ring. But gross lenticular subluxation with significant zonular weakness is better managed with the use of a Cionni ring. So far the technique described for Cionni ring implantation required either preplaced sutures or an ab interno approach with the needles holding the suture for fixation of the ring being inserted from within outside. An ab externo approach has been described for inferior fixation of the Cionni ring. We describe a novel technique for the insertion and superior fixation of the Cionni using an inverse ab externo approach with two passes of the straight needle, first inferiorly and then towards the point of fixation.

TRT: 10:00 min

Management of Traumatic and Dislocated Cataract

Author by: Dr. Nibaran Gangopadhyay
Year of Publication: May 2004

A series of traumatic, ruptured or dislocated cataracts were managed successfully through complicated surgical procedures, with or without endocapsular ring where indicated. Posterior segment evaluation was found to be normal in each case. Good visual outcome followed by appropriate refractive rehabilitation was achieved in all patients. Preoperative detailed slit lamp evaluation by the surgeon concerned, B-Scan ultrasonography and meticulous surgical techniques were key factors for good results.

TRT: 09:08 minutes

Management of Traumatic Graft Dehiscence

Author by: Dr. Pravin Vaddavalli Krishna
Year of Publication: 2005

Traumatic graft dehiscence after penetrating keratoplasty is a life long postoperative concern. Such traumatic dehiscence has been reported upto 14 years after surgery. Although graft survival and visual outcome are generally poor after the injury, the restoration of a satisfactory visual result is possible after regrafting, insofar as the involved eye is free of intractable glaucoma or posterior segment damage. The video demonstrates the management and outcome of a case of traumatic graft dehiscence.

TRT: 08:50 min

Management of Posterior Lenticonus with Cataract

Author by: Dr. Nibaran Gangopadhyay
Year of Publication: May 2004

A case series diagnosed as having posterior lenticonus with cataract presented in the paediatric age group, was reviewed retrospectively. A detailed slit lamp evaluation had helped in the preoperative diagnosis except in six who were diagnosed intraoperatively. All of them were associated with amblyopia. Good surgical outcome was achieved in all these cases through meticulous and demanding technique. This video demonstrates the slit lamp evaluation and surgical technique about how to diagnose and manage anterior and posterior lenticonus with cataract.

TRT: 08:57 minutes

Awards: Invited for publication in the Video Journal of Cataract and Refractive Surgery, USA, October 2004

First Prize - Cataract Surgery

Film Festival of the American Society of Cataract and Refractive Surgery ASCRS 2005 Annual Symposium and Congress, April 15-20, 2005

Scleral-Fixated Intraocular Lens Implantation: Indications, Surgical Technique and Complications

Authors by: Dr Fernandes Merle, Dr Avinash Pathengay, Dr Aasuri Murali Krishnamachary
Year of Publication: August 2004

Posterior chamber intraocular lens implantation is the standard of care for cataract surgery. In the absence of adequate capsular support for posterior chamber intraocular lens implantation, an intraocular lens may be placed in the anterior chamber, supported in the angle or on the iris. Scleral-fixated intraocular lens implantation has emerged as a suitable, more physiological alternative for lens implantation in the absence of capsular support. In this video, we will describe the indications, contraindications, surgical techniques and complications of scleral-fixated intraocular lens implantation.

TRT: 10:00 minutes

Surgical Management of Complicated Cataract with Bound-Down Pupil

Author by: Dr Mandal Anil Kumar
Year of Publication: April 2003

Patients with poorly dilating pupils and complicated cataract present significant challenge to surgeon. This video highlights a technique used in the management of a case of complicated cataract and small pupil with 360 degree posterior synechia. First, a peripheral corneal incision is made followed by keyhole iridectomy. This is followed by endocapsular cataract extraction using envelope technique. The split open iris is sutured with 10-0 prolene, one suture at pupillary margin and one at apex of iridectomy, thus restoring integrity of anterior segment. It is a safe and easy-to-learn procedure that can make complicated cases simpler.

Duration: 09:56 min

Management of Complicated Cataract with Bogged-down Pupil

Author by: Dr Rupesh Aggarwal
Year of Publication: 2008

A bogged-down pupil is seen in about 25 to 30 percent of patients presenting with complicated cataract. The pupil gets plastered onto the anterior surface of the lens, owing to recurrent attacks of inflammation in the anterior segment of the eye. It is commonly seen in patients with long-standing complicated cataract with poorly-controlled intraocular inflammation and in patients who do not regularly attend follow-up consultations with their treating ophthalmologist. We demonstrate the surgical management of complicated cataract with bogged-down pupil, illustrating the surgical difficulties as well as the techniques to overcome surgical complications.

Duration: 07:05 minutes

Two Rings and an Intraocular Lens Implant - All in the Bag

Author by: Dr.Merle Fernandes
Year of Publication: May 2006

This video describes an innovative surgery in a patient with 3 quadrants of zonulodialysis with traumatic cataract. After phacoemulsification, two Cionni rings were used for stabilization of the capsular bag with implantation of an intraocular lens in the bag. Post operatively, the bag and all its contents were stable and the patient has minimal inflammation with good visual recovery.

Duration: 06:57 min

Use of Capsular Tension Ring in Subluxated Cataract Surgery

Authors by: Dr.Rohit Khanna, Dr.Srivalli Kaza, Dr.Gaurav Gupta
Year of Publication: 2008

Performing phacoemulsification is a challenge in the event of a pre-existing or intra-operative zonular compromise. Capsular support devices enable the surgeon to have improved capsular stability intraoperatively for safer cataract removal. Achieving satisfactory phacoemulsification and ensuring in-the-bag intraocular lens implantation is possible with the judicious use of endocapsular support devices.

Duration: 09:44 minutes

Pot-pourri of Shocks & Surprises - Tackling the Posterior Capsule in a Posterior Polar Cataract

Authors by: Dr. Srivalli Kaza, Dr. Rohit C Khanna, Dr Geeta Vemuganti
Year of Publication: 2008

Posterior polar cataract is one of the more common types of congenital cataract said to be due to remnants of hyaloid system and invasion of lens by mesoblastic tissue. It presents a unique challenge to all surgeons because it warrants removal of a soft nucleus and also protection of a weak posterior capsule. If adequate care is not taken, it can give a rude shock to the surgeon-that of a nucleus drop! This video covers a few scenarios of posterior polar cataract-a nucleus drop, a successfully handled case, and one which had iris tissue on the abnormal posterior capsule histopathologically proving its origin from mesoblastic tissue.

Duration: 10:00 minutes

Blumenthal SICS with Trabeculectomy in Phacomorphic Glaucoma

Authors by: Dr Khanna Rohit, Dr Tejwani Sushma
Year of Publication: September, 2005

Blumenthal manual SICS is an established procedure for cataract surgery. This video shows Blumenthal SICS with trabeculectomy being performed in a difficult situation, that is, in a case of phacomorphic glaucoma with adherent leucoma. The difficulty is in performing a large capsulorhexis in phacomorphic glaucoma given the small pupil and increased intralenticular pressure. Here, Blumenthal SICS is performed along with trabeculectomy using a Kelly’s punch. The Kelly’s punch helps to perform deep sclerectomy and we illustrate its advantages over the use of a blade or scissors.

TRT: 09:27 min

Phacotrabeculectomy: A Modified Simple Technique

Author by: Dr Mandal Anil Kumar
Year of Publication: March 2002

To perform 'Single incision phacotrabeculectomy' surgery, one usually converts the standard scleral tunnel incision that is used for phacoemulsification, into a scleral flap. However, this intraoperative video illustrates a modified technique of single incision phacotrabeculectomy, that circumvents the need for a standard scleral tunnel. The technique is demonstrated for the surgeon who is already familiar with phacoemulsification. The advantages are that the technique is safe, quick and easily reproducible, making it a method of choice for the surgeon to manage cataract with coexisting glaucoma.

Duration: 16:47 minutes

Two-Stage Management of Thin-Walled Overhanging Bleb with Cataract

Author by: Dr Mandal Anil Kumar
Year of Publication: March 2005

This video demonstrates the repair of a thin walled overhanging bleb followed by corneal section cataract extraction at a later date. After excision of the overhanging bleb free autologous conjunctival grafting was performed by transplanting a large graft from the superotemporal bulbar area of the same eye to the filtering site. After 4 months, superior corneal section cataract extraction and PC IOL implantation was performed and the patient gained a visual acuity of 20/20 with minimal induced astigmatism. Six months after cataract extraction, the patient was maintaining good IOP control without medication and well functioning filtering bleb.

Duration: 08:22 minutes