Following blunt trauma this girl presented with vitreous in the AC - formed vitreous - also a GRT (Giant Retinal Tear). At surgery, I thought that getting the vitreous out of the way in the AC - could be a good idea - so after instilling some Kenalog into AC to highlight Vit, I tried injecting into AC to push vit back into PC - did it work? - Watch the video and comment...
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I guess it did not work. Whats the next move u did? its not shown here in the video
ReplyDeleteYou're right, in this case it didn't work - I think it was because I was injecting BSS, rather than viscoelastic. I had thought that if I could get the vitreous out of the way, I could do phaco and the proceed to a pars plana vitrectomy for the giant tear, but ended up doing a pars plana lensectomy and then approaching the retinal problem...
ReplyDeleter u planning for a scleral fix iol in the future
ReplyDeleteYes, when I take the oil out.
ReplyDeleteAnother option could have been anterior vitrectomy, Capsular tension ring with scleral fixation, in the bag IOL, and then proceed with retinal surgery.
ReplyDeleteHi, yes have done that for some other cases, but for this one the visual prognosis was uncertain so I thought it best to leave her aphakic at initial surgery. Once retina has settled, one can better assess the visual prognosis and if there is reasonable potential vision then put in a secondary IOL at the time of oil removal, or if not than leave they eye aphakic.My thinking on this case anyway.
ReplyDeleteOf course there are different valid approaches to complex cases....