Soft Posterior Polar

Here is a posterior polar case that went OK the pt was about 15 and havingsignificant glarte and a decline in best corrected VA.

Posterior polar cataracts are tricky as the polar cataract is often conntected to the posterior capsule andremoving it can leave a hole in the posterior capsule. The most important tip is to not hydrodissect as in a typical case as the fluid wave can easily blow out the posterior capsule in these cases. I like to first sculpt out a bowl so that any fluid force can simply compress the lens onto itself rather than blow out the capsule. After sculpting out the bowl, try hydrodilenation and viscodissection. In this case, the lens was so soft t that i could simply use the I/A device to remove all of the lens material. I used the cortical fibres to dissect the soft lens material into the middle. Fortunately, the posterior polar cataract was not firmly attached to the posterior capsule and ther was no tear in the capsule following removal of the lens material.

The other interesting issue was the anterior capsule. In a 15 year-old the capsule is very elastic. Tt behaves much like the capsule of the pig that we can experience in the wet lab. The rhexis is different as you must use shear forces rather than leading the tear like a sier. You often must lift the capsule up and directly inward to keep the elastic anterior capsule from going out.

Thanks for any comments. tom o

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Education

Tags:

• cataract surgery
• posterior polar