Patient NEEDS HELP after RLE with Panoptix - IOL Exchange
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- Опубликовано: 3 окт 2024
- This nice patient was a high myope and underwent Refractive Lens Exchange (RLE) to eliminate the need for glasses. She had the Panoptix Lens implanted in both eyes. While her first eye did very well from the start, the same couldn't be said for her second eye. She had significant capsular contraction and a decentered multifocal lens. She underwent a subsequent surgery to try and center the lens. During that surgery, a CTR was placed. However during placement, it wasn't positioned properly and sat partially behind the iris, and partially in front of the iris. During a maneuver to reposition the CTR, the patient started bleeding which hindered the surgeon's view. Afterwards, the patient experienced significant pain and very poor vision. She was referred to me to exchange her IOL and to assess her CTR for possible repositioning.
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Great video as always.
One method to help in your hunt for the CTR would be to use a gonio prism. Can use a bit of visco to tent up the iris a bit and give some visualization of the sulcus/peripheral bag. love your videos man
What did you use for the slit lamp capture ?
Was wondering the same thing
Cataract surgery is not benign people. We too often state that this is going to be easy and you’ll see better than ever. Until you end up with multiple surgeries and a CTR in an unknown location. Crazy. Good work on helping her.
Excellent case. If you have ECP.. it will be great to use its camera to search for the CTR..
Thank you🌹
Great case. This is why I don't do RLE anymore. Capsules contract and outcomes are not always predictable. Contraction seems worse in younger patients. I probably would have used an indirect goniolens and tried to drive the eye, pushing into different gaze positions to help look farther into the sulcus and capsule. I love that you give the original surgeon credit and not bash them for an undesirable outcome.
I came to the comments section to see if any experienced surgeons would have tried to use a gonio lens. I have not encountered a situation like this before, but while watching this video, I thought I might have tried a gonio lens to visualize the CTR. Great case, thanks for sharing.
Impressive