3. Pathophysiology
The mechanism in blunt traumatic lens dislocation
is due to a compressional anterior-posterior force
of the cornea and anterior sclera causing rapid
compensatory equatorial expansion of the globe.
As a result, the zonular fibers, which anchor the
lens to the eye, may become stretched or
damaged.
Partial zonular dialysis may lead to subluxation
while complete zonular rupture leads to
complete luxation.
13. Degree of zonular dehicense
Up to 4 clock hours
CTR with IOL implantation
3 to 6 clock hours
modified CTR with single loop
6-9 clock hours
modified CTR with double loop
With IOL implantation in the bag or the sulcus
More than 9 clock hours
Pars plana Lensectomy
Vitrectomy probe (clear)
Fragmatome (cataractus)
with scleral fixed IOLS,anterior chamber IOLS
Iris fixed IOLS
14. Perferably away from area of zonular
weakness.
Use high molecular weight viscoelastic.
Capsulorrhexis should be intiated in area
remote from the dialysis.
Capsulorrhexis is more easily performed with
forceps , should be made off center in an eye
with significant lens subluxation
15.
16. Good sized rhexis
supra capsular technique to decrease stress
over the zonules
Visco elevation
17. Devices used in surgery
Capsular tension ring
Indication
1-Missing or damaged zonules
2-Lens subluxation
3-PEX
4-High myopia
5-Marfan syndrome
Mechanism
Circular expansion of the bag
Stable condition during surgery
Improve IOL centration
Reduced risk of capsular fibrosis
Resist capsular shrinkage
