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PC Rent with Nucleus / IOL

Drop

PC Rent with Nucleus / IOL

Drop Sr.Panchavarnam

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The whole or partial nucleus drop into the vitreous

Definition:

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OccurrenceOccurrenceOccurrenceOccurrence

Small capsula Rhexis

During excess hydro

dissection

During nucleus delivery

Hard Nucleus

Weak Zonulers

PXF

Subluxated lens

Rhexis extention

i. PPC (Posterior Polar Cataract)

If Hydro dissection is done

ii. Traumatic Cataract

PHACO Sculpting

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Signs of nucleus dropSigns of nucleus dropSigns of nucleus dropSigns of nucleus drop

AC deep – Anterior chamber will be deep

Difficulty in delivering nucleus with

Sinske –suspect impending PCR Nucleus drop

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ManagementManagementManagementManagement If the nucleus drops occur, instruments should not be used to

take it out, because this will affect the retina (eg. i. Retinal detachment ii.Choroid Detachment)

Immediately approach the Retina specialist. Retina specialist will do Vitrectomy and bring out the nucleus if

there is small posterior capsule rent PC IOL could be placed If the posterior capsule is ruptured, PC IOL cannot be

implanted. Patient can be reviewed after 1 month, and corneal status assessed and decided for secondary IOL If necessary after three months AC IOL could be implanted.

This could be avoided for old age people, corneal problempatients.

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Complications (Post Complications (Post Operative)Operative)

Complications (Post Complications (Post Operative)Operative)

Retinal Detachment

Chordial detachment

Vitreous Haemorrhage

Aphakic Glaucoma or Pseudo Aphakic

Glaucoma

Inflammation

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IOL DropIOL DropIOL DropIOL Drop

During the cataract surgery if the

implanted lens drops into the vitreous

the condition is called as IOL drop

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ReasonsReasonsReasonsReasons

Posterior capsule rent

IOL dialing

Zonular dialysis

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ManagementManagementManagementManagement

If there is vitreous disturbance Vitrectomy has to be

done

Retina surgeon is to be called to remove the lens

If the lens could be placed in the sulcus it could be done

otherwise leave it aphakic.

After one month, if the inflammation is reduced, we can

check whether the IOL could be placed.

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