PC Rent with Nucleus / IOL Drop

1. PC Rent with Nucleus / IOL Drop Sr.Panchavarnam ARAVIND EYE CARE SYSTEMS

2. Definition: The whole or partial nucleus drop into the vitreous ARAVIND EYE CARE SYSTEMS

3. Occurrence • Small capsula Rhexis • During excess hydro • dissection • During nucleus delivery • Hard Nucleus • Weak Zonulers • PXF • Subluxated lens • Rhexis extention • i. PPC (Posterior Polar Cataract) • If Hydro dissection is done • ii. Traumatic Cataract • PHACO Sculpting ARAVIND EYE CARE SYSTEMS

4. Signs of nucleus drop • AC deep – Anterior chamber will be deep • Difficulty in delivering nucleus with • Sinske –suspect impending PCR Nucleus drop ARAVIND EYE CARE SYSTEMS

5. Management • If the nucleus drops occur, instruments should not be used to • take it out, because this will affect the retina (eg. i. Retinal • detachment ii.Choroid Detachment) • Immediately approach the Retina specialist. • Retina specialist will do Vitrectomy and bring out the nucleus if • there is small posterior capsule rent PC IOL could be placed • If the posterior capsule is ruptured, PC IOL cannot be • implanted. Patient can be reviewed after 1 month, and corneal status assessed and decided for secondary IOL • If necessary after three months AC IOL could be implanted. • This could be avoided for old age people, corneal problem • patients. ARAVIND EYE CARE SYSTEMS

6. Complications (Post Operative) • Retinal Detachment • Chordial detachment • Vitreous Haemorrhage • Aphakic Glaucoma or Pseudo Aphakic • Glaucoma • Inflammation ARAVIND EYE CARE SYSTEMS

7. IOL Drop During the cataract surgery if the implanted lens drops into the vitreous the condition is called as IOL drop ARAVIND EYE CARE SYSTEMS

8. Reasons • Posterior capsule rent • IOL dialing • Zonular dialysis ARAVIND EYE CARE SYSTEMS

9. Management • If there is vitreous disturbance Vitrectomy has to be done • Retina surgeon is to be called to remove the lens • If the lens could be placed in the sulcus it could be done • otherwise leave it aphakic. • After one month, if the inflammation is reduced, we can • check whether the IOL could be placed. ARAVIND EYE CARE SYSTEMS

10. Thank You ARAVIND EYE CARE SYSTEMS