ASCRS•ASOA SYMPOSIUM & CONGRESS, BOSTON 2014
Dr. Jacob describes a technique she developed over the last few months at the
"Complicated and Challenging Cases in Cataract Surgery Video Symposium."
the sclera, at—significantly, he
pointed out—a single point.
He then proceeded to perform
capsulorhexis, which was made
difficult by the subluxation and sub-
sequently complicated by vitreous
escaping into the anterior chamber.
After clearing away some of
the vitreous, he inserted the phaco
probe, which caught the iris. He
freed the iris and decided to bring
the nucleus out of the bag. The iris
caught once more, at which point,
said, Dr. Agarwal, "I should not pull
out."
"I pulled out," he said.
The iris prolapsed, though the
iris suture remained in place. He
then had to go after the nucleus,
which had dropped. He performed a
complete vitrectomy, excised the iris
creating iatrogenic aniridia—"Is
there any hole deep enough where I
can go bury myself?" he said he
asked himself at that point—lifted
the nucleus and removed it en bloc.
Finally, he implanted a single-
piece, non-foldable aniridia IOL
using the handshake technique,
securing the haptics in Scharioth
tunnels in the sclera and gluing
everything down.
This series of unfortunate
events—tackled with Viking resolve
and managed with an impressively
level head—received the most votes
from the audience and so won the
Golden Apple Award.
EW
Editors' note: The doctors have no
related financial interests.
