Capsulophimosis Small diameter CCC 1. 2. Weak zonules x 360 3. - PowerPoint PPT Presentation

12/3/2016 Use CTR if any zonulopathy 1. If no CTR, use 3-pc acrylic 2. Larger CCC diameter or radial cuts 3. David F. Chang, MD 3-pc IOL in sulcus + CCC capture 4. Clinical Professor UCSF Cionni or Malyugin ring/Ahmed CTS 5. AMO Consultant Fees donated (Project Vision, Himalayan Cataract Project) Capsulophimosis Small diameter CCC 1. 2. Weak zonules x 360 3. Capsulotomy - sphincter CTR after IOL 1

12/3/2016 Gills Uthoff scissors NO CTR: Secondary enlargement 1. Better red reflex; no ant caps convexity 3-pc haptic – more compressive force Increased capsular tension (haptics) Partial slits to CCC edge Less capsular fibrosis with hydrophobic acrylic 2. Optic = diameter template Radial tear ok 84yo PXF (hx trabeculectomy) What is the FIRST Perfect surgery … until I thing you should do? make a BIG mistake 8 2

12/3/2016 1. Leave it alone? 2. Suture CTR to sclera 3. Suture haptic to iris Would you jiggle the eye? 4. Move it to sulcus Yes – jiggle it and see 5. Sulcus + iris suture No – quit right now! 6. AC IOL 9 Pseudoexfoliation – Diffuse Zonulopathy + Optic capture Same eye – Same 3-piece IOL Prevents CCC contraction 1) In bag 2) In sulcus Good centration Additional 2 point fixation during eye movement Prevents rotation (e.g. through dialysis) (Haptic – Ciliary body) No IOL power adjustment 11 12 3

12/3/2016 Use CTR if any zonulopathy 1. If no CTR, use 3-pc acrylic 2. Larger CCC diameter or radial cuts 3. 3-pc IOL in sulcus + CCC capture Ahmed Capsule Tension 4. Malyugin CTR Segment (FCI Ophthalmic/Morcher) Cionni or Malyugin ring/Ahmed CTS 5. (FCI Ophthalmic/Morcher) 4