Lens Escapades: Manual Rhexis Underneath a Lens
Title:Lens Escapades: Manual Rhexis Underneath a Lens
Author: Austin S. Nakatsuka, MD
Date: 03/12/2025
Brief Description: In this video, we have a 3 piece lens in the sulcus space causing uveitis-glaucoma-hyphema (UGH) syndrome. The goal is to OPTIC CAPTURE the lens, which means to move the optic part of the lens behind the capsule (the posterior and anterior capsule have already fused together and the posterior capsule is open) while the haptics are still in the sulcus space above the capsule. The difficulty in this case is the capsule if already fused/fibrosed/scarred together. That means it is less pliable and can be easier to break when moving the optic in place. In this case, the opening where the optic needs to go through is too small. So I have to lift the lens into the anterior chamber and enlarge the rhexis opening UNDERNEATH the lens, which is tricky to do. I do this with a microscissors and Utradas forceps and manually enlarge the rhexis opening. I choose to do this instead of using a vitrector because even though I have done so with the vitrector, I feel that it can make the capsule opening weaker and easier to break. Also, I don’t really want too much fluid flowing through the eye when I have a lens that can fall. It was tricky, but I was able to enlarge the rhexis opening and then successfully “optic capture” the lens.
Format: mp4
Identifier: Moran_CORE_127884
Copyright statement: Austin S. Nakatsuka, ©2025. For further information regarding the rights to this collection, please visit: http://morancore.utah.edu/terms-of-use/
