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    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.