JAN 15, 2014
Traumatic Cataract: Managing Vitreous Prolapse
By David F. Chang, MD
Annual Meeting 2013
Cataract/Anterior Segment
This case of a traumatic cataract with a truncated lens equator demonstrates several pearls for the prevention and management of vitreous prolapse. A dispersive ophthalmic viscosurgical device (OVD) can be used at the area of zonular dialysis, and capsule retractors help prevent further zonular dialysis. Bimanual irrigation/aspiration dissociates the infusion and aspiration ports to minimize posterior misdirection of irrigation fluid. Following insertion of a capsular tension ring (CTR), sulcus placement of a 3-piece IOL with continuous curvilinear capsulorrhexis capture ensures stability and centration of the IOL. Finally, triamcinolone staining reveals occult vitreous prolapse that can be managed with a pars plana anterior vitrectomy to remove and prevent further vitreous prolapse into the anterior chamber.