5. When to Remove Dropped Nucleus
Dr Nitin Prabhudesai
• Ideally any amount of dropped nucleus
should be removed
• Most Nuclear fragments incite an
inflammatory reaction & rise in IOP
• No attempt to “Fish Out’’ the nucleus
hastily
• Anterior Vitrectomy with closure of
wound
6. Should IOL be placed ?
• If the Anterior Capsular rim is intact
IOL can be placed
• If Capsular support not adequate
– Anterior chamber IOL
– Iris claw IOL
Dr Nitin Prabhudesai
7. When to remove Dropped IOL
• Visual disturbances
• Retinal defects
Dr Nitin Prabhudesai
8. How to remove Nuclear Fragments
• 3 port Vitrectomy
• Fragmatome for larger & harder cases
• PFCL use to float the Nucleus
• Vitrectomy Cutter for softer cases
• Placement of IOL
• Secondary IOL
Dr Nitin Prabhudesai
9. Secondary IOL
• Choice of Secondary IOL after Primary surgery
– IOL on capsular rim
– Scleral Fixated IOL
– Glued IOL
Dr Nitin Prabhudesai
10. IOL removal
• 3 port Vitrectomy
• IOL removal
• Placement of secondary
IOL
Dr Nitin Prabhudesai