Name

Luxation de la lentille dans l'humeur vitrée -système de visionnage moins conventionnel-

This paper presents, by the use of videos,the case of a patient to whom during cataract surgery(phacoemulsification procedure) is noted the existence of a posterior capsular rupture with crystalline lens fragments dislocated into the vitreous. 

The surgery goal was consisted of facoemulsification and  foldable hydrophobic acrylic intraocular lens implant.

The steps of the surgical intervention were : 2.2 mm incision in the clear cornea, contraincision, anterior vascular restoration, circulatory capsulorhexis, hydrodissection, hydrodelination, divide and conquer method.

At the end of the surgery,is observed  the rupture of the posterior capsule with the migration of a residue of crystalline fragment and outstanding crystalline masses.

Cataract surgery goes on with 25Ga vitrectomy,placement of the cold light source and vitrectomy infusion source. Introducing an air bubble into the anterior chamber allows us to clearly observe detail in the posterior pole and perform vitrectomy with fragments removal as seen in the film. This viewing path was chosen due to the fact that conventional viewing means were not available at that time.

We have found that bubble buildup in the viscoelastic substance, this diopter, is optically stable enough to provide a comfortable view of the posterior pole details. The intraoperative viewing field is quite small, we appreciate it at 10 degrees, but provide a clear view as long as the air bubble in the previous chamber is stable.

Removal of the crystalline residue could only be achieved with the vitreotome practicing a "Chop" with the help of the light source.We consider this viewing method to be useful in cases where conventional viewing media are not available.

The surgery is over with intraocular lens implant in the ciliary sulcus and postintervention good results.