Standard Glued IOL surgery
by Boral Subhendu Kumar

Retina & Vitreous Surgery: A Practical Guide to Theory, Practice and Management

by Subhendu Kumar Boral, Suber S Huang
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This video demonstrates standard glued IOL surgery. A case of decentered polymethyl methacrylate (PMMA) IOL with large posterior capsular rent. Retro-IOL vitreous removed. IOL prolapsed in anterior chamber and then removed. Triamcinolone injected in anterior vitreous to check for vitreous prolapse. Superior capsular remnant removed. TA stained prolapsed vitreous removed. Vitrectomy completed. Vitreous-based excision done by external scleral depression. Conjunctival flaps made 180 degrees apart along 3 and 9 o’clock. Marking done to make scleral flaps with a scleral marker. 2 mm base/2 mm length scleral flap made 2 mm away from the limbus. Similar scleral flap made in opposite side. Pars plana separate entry were made at the base of scleral flaps with 23G trocar blade. Now, a 23G end gripping forceps was introduced through left pars plana scleral tunnel. A multipiece IOL introduced through the main scleral tunnel. Forceps should hold the tip of inferior haptics and it was taken out of sclera tunnel. Superior haptic also introduced and it was made out of scleral tunnel. Linear scleral tunnels were made inferiorly and superiorly at the sides of scleral flaps by a 26G needle parallel to the limbus. Haptic tips had been engaged to the linear scleral tunnel (Scharioth tunnel) in both sides. Now two drops of fibrin glue were applied at the base of scleral flaps and they were firmly apposed to the base. Now conjunctival wounds closed similarly with the help of the same glue.

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