JAN 19, 2024
A Case of Traumatic Zonulopathy: MX60E Serendipity
AAO 2023 Video Program
Cataract/Anterior Segment, Complications, IOLs and Implantation
DW is a 65-year-old woman who underwent cataract surgery 2 years prior by another surgeon. She presented to me with a chief complaint of vision loss after a "finger poke" to her right eye 6 months prior. On exam, she had hand-motion vision and a 2-mm pupil; the visual access was blocked by opaque capsule, IOP was 16, angle recession appeared on gonioscopy. Dilated exam revealed a subluxated MX60E IOL with a capsular tension ring (CTR) in the bag. There was vitreous prolapse from around the IOL/CTR complex. What to do next? Remove the whole IOL/CTR complex and perform scleral fixation of the IOL? Preserve the complex and reattach it? And how? After giving it some thought, I performed the McCabe belt loop technique to refixate the entire complex to the scleral wall. Fortunately for my patient, the implanted IOL (MX60E) has fenestration holes, which allowed me to perform two secure belt loops and carefully center the optic. The patient saw 20/40 without correction on postop day 1.