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Occult Posterior capsular rent
- 1. Occult PCR BY DR INDEEVAR V MISHRA, GLAUCOMA AND ANTERIOR SEGMENT SURGEON M M JOSHI EYE HOSPITAL.
- 2. “Occult” – ‘mystical, supernatural, or magical powers, practices, or phenomena.’ However it can also mean – ‘ Hidden, Secretive…’
- 3. Occult PCR Defined as “A preexisting breach in the capsular integrity which may be a direct or indirect result of a pathological external influence presenting itself before or during the course of the cataract surgery and is not as a resultant of the maneuvers of the operating surgeon.”
- 4. Causes Anterior 1. Blunt Trauma 2. Penetrating Injuries. Posterior 1. Vitrectomised eyes 2. Intravitreal injections 3. IOFB / IOFBr 4. Miscellaneous posterior segment surgeries. Miscellaneous 1. Resident’s / Trainee’s case.
- 5. Trauma – Physical Trauma • Incidence of ocular injuries in India is estimated to be 20.5%. • Males share the major burden… • Mechanism – Direct, Coup contrecoup, Equitorial expansion, permutation and/or combination of the above.
- 9. Pre operative - Investigations • Detailed Slit lamp examination • AS – OCT • UBM / 20 MHz echography* * Ali Tabatabaei, MD et al, ‘Accuracy of 3 imaging modalities for evaluation of the posterior lens capsule in traumatic cataract.’ Journal of Cataract & Refractive Surgery, Volume 40, Issue 7, July 2014.
- 10. Intraoperative Signs Courtesy – Dr Arup C Sir
- 12. Intraoperative Signs …. 1. Blocked tip 2. Stuck on look of the Nuclear fragments.. 3. Shallowing of the Ac 4. Nucleus drop…
- 13. Management.. • AC Phaco • Viscoelastic Pump – Dr Arup Bhaumik • Scaffold IOL method – Dr Soosan Jacob • Pars Plana Vitrectomy for anterior segment surgeons – Dr David Chang. • PAL – Posterior assisted levitation – Dr Charles Kelman.
- 14. Thank u!!!
Editor's Notes
- Intravitreal injections are proving to be a boon as well as a burden….in wrong and untrained hands….spelling disasters for cataract surgeons…