Surgical Videos

Complications of Cataract Surgery including Lens Fragments and Dislocated IOL; Submacular Surgery (Scar Removal); Choroidal Hemorrhage Drainage; Cyclodialysis Cleft Closure; Ahmed Valve.

Lens Fragments and Dislocated IOL
Iris Fixation

This patient had cataract surgery and some of the fragments from the surgery dropped into the vitreous. They are removed and then the intra-ocular lens, which is not stable, is sutured to the iris for stability.

Dislocated IOL
Trans-scleral Fixation

This is a novel technique to secure a dislocated intraocular lens using a 9-0 prolene suture that allows the suture and the knot to both be completely buried at the end of the surgery without the need to make a scleral tunnel.

Removal 2 Dislocated IOLs
Scleral Incision

This 80 year old man had a dislocated, in-the-bag, intraocular lens. He had a previous pars plana vitrectomy. His cataract surgeon attempted an iris suture intraocular lens as a replacement and that fell into the vitreous cavity. Then, at the same sitting, the surgeon placed an anterior chamber intraocular lens. About 1 week later, the second posterior chamber intraocular lens moved forward and wedged itself in between the iris and the haptic of the anterior chamber intraocular lens. The patient then developed corneal edema. After removing these two lenses, the corneal edema cleared in about one month.

In-the-bag Dislocated IOL
Scleral Suture

80 year old woman who had a lens exchange for an anterior chamber intraocular lens 3 years ago in the fellow eye and now had chronic cystoid macular edema controlled with every 6 months posterior subtenon's Kenalog. The intraocular lens dislocated in the right eye about 1 month ago and the vision is hazy. This procedure is an excellent option for dislocated silicone plate intraocular lenses because the fixation hole in the intraocular lens can be used to suture the lens to the sclera.

Choroidal Hemorrhage Drainage
Ligation of Baerveldt Tube

83 year old man had macular hole surgery in 1996 and his visual acuity improved to 20/50. 2 months prior to this video he had a Baerveldt Implant in his left eye and his intraocular pressure was low (less than 6). He developed a choroidal hemorrhage 3 weeks prior to this video. By the time of the surgery, the blood had liquified and drained easily. The video is sped up to double speed during the drainage of the choroidal hemorrhage parts. The patient regained 20/100 vision at the time I am posting this which is one month post-operatively. Even thought the drainage tube was ligated, his intraocular pressure was still low at about 6 mmHg after this surgery.

Cyclodialysis Cleft Closure
for Hypotony Maculopathy

This 79 year old man had a cyclodialysis cleft and, despite has advanced age, vision loss from hypotony maculopathy. His intraocular pressure before the procedure was 6 mmHg. He had been treated for 4 months with drops and twice with cryotherapy to the cleft. After the procedure his intraocular pressure increased to 26 mmHg and his vision improved from 20/200 to 20/60.

Ahmed Valve
with Scleral Buckle Revision

This patient had narrow / angle closure glaucoma and a corneal graft. She has had 10 previous surgeries. In order to make room for the Ahmed Valve plate, a piece of the scleral buckle is removed.

Lens Fragments
Vitrectomy

Removal of retained lens fragments and insertion of secondary anterior chamber intraocular lens. This 70 year old woman had cataract surgery 2 days previously. At the time of surgery some of the cataract lens dislocated into the vitreous cavity. The operating surgeon chose not to insert an intraocular lens at the time of the cataract surgery. This video shows the removal of the lens fragments and the insertion of the secondary intraocular lens.

Dislocated IOL
Capture Optic in Capsulotomy

Macular pucker surgery using 25 gauge small incision "no stitch" system and repositioning of decentered intraocular lens, This 67 year old white male has noticed decreased vision in his left eye for one year. He had a cataract surgery one year ago. His vision did not improve. It looked like he had a thumbprint in front of his lens. Then aout six months ago he noticed his vision becoming more foggy. He is diabetic for 18 years and has high cholesterol, high blood pressure and heart disease. He was recently diagnosed with glaucoma and started on a pressure lowering eye drop. His visual acuity on presentaiton was 20/50 in each eye. His intraocular lens was displaced superiorly in each eye. In the left eye the intraocular lens was displaced enough so that the edge of the lens was at the visual axis. His left eye also had a macular pucker. He also had optic nerve cupping in each eye.

Ahmed Valve
Neovascular Glaucoma

Placement of an Ahmed valve with the drainage tube in the anterior chamber in an eye with unconrolled neovascular glaucoma. This 81 year old man has been managed for 3 months with laser, drops and oral medications for neovascular glaucoma induced by a central retinal vein occlusion. His intraocular pressure is between 30 and 40 despite maximal medical therapy. He also has a history of heart failure. Some of his glaucoma medications cannot be continued without risk of exacerbating his heart disease. His visual acuity is 20/160 in this eye. His other eye is 20/60 because of a macular pucker.

Sub-Macular Surgery
Removal Sub Macular Scar

Removal of a Subretinal Neovascular Membrane in an eye with Ocular Histoplasmosis Syndrome. This video is about 7 minutes long and shows a 20 gauge vitrectomy. The patient has 20/400 visual acuity from a subretinal neovascular membrane. He has had previous laser for ocular histoplasmosis syndrome