For your Muslim patients, you must make them aware that this lens contain collamer, i.e., made up of pork derived collagen. So then it depends on them to make their decisions.

can we see the day after the iol centration?

That first blade was awful dull.

Pour éviter les complications, faites une incision entre 6 et 7 mm

That forceps name sir

By the way I started doing bimanula IA since my residents all did it at the hospital. I never went back. It’s so much better and takes only 1 minute more of time.

Classic example of surgeon denial. We all have made this blunder- maybe we have so many cases left to do and we hope we can finish then case without taking the time to put in hooks. I bet if this were the last case of the day, he would have taken care of the iris right away. So kudos to the surgeon for posting. And let’s re- learn that lesson- if you even THINK of putting in iris or capsule hooks etc, JUST DO IT. Your initial instinct is correct 99% of the time

Classic example of surgeon denial. We all have made this blunder- maybe we have so many cases left to do and we hope we can finish then case without taking the time to put in hooks. I bet if this were the last case of the day, he would have taken care of the iris right away. So kudos to the surgeon for posting. And let’s re- learn that lesson- if you even THINK of putting in iris or capsule hooks etc, JUST DO IT. Your initial instinct is correct 99% of the time

Fantastic

Still we can implant a single piece IOL in the bag, even in the presence of large PC rent. In an adult with a more liquid vitreous, I would do reverse optic capture. Nice job Thanks for sharing, and the excellent teaching narrative.

Nice surgical skills, I must say. Just one thing, Can try emulsifying the pieces In the bag instead of bringing it out of the completely in the AC. Just so that it is away from the endothelium.

Really fascinating interview with Dr Cummings - the "avatar" eye with backward ray tracing laser, the not so "permanent" surgery idea with ICL's and especially enjoy your 60's and don't wait till near the end of your life to retire. This was a really great interview that all eye doctors should listen to!

❤❤❤❤

Nice

Does this modified incision have any additional effect on astigmatism? Thanks

That was amazing.

Great technique! My only comment is that there is too much turbulence of the nuclear fragments in the AC hitting the endothelium, it might cause post op corneal edema.

which chopper did the surgeon use?

First comment. Super young lady 🤗

Bb. ,?

Excellent hands!

I see your approach is temporal, but in the case of superior approach, incisión won't be at 180, so in that case, WhatsApp do You think about migrating from 2.75 to 2.2mm?

Happened to me just this Monday when i was operating on a white cataract. Thanks for the video explanation👏🏻

Sir, what is the model of capsulorhexis forceps that you have used here....?

There is a lot of mumbo-jumbo in this video. You can talk about the physics all day long, but how does that really translate to the actual patient experience ? I had 2 vivity lenses implanted 2 years ago at age 63. I developed cataracts as a result of getting bi-lateral vitrectomies. I chose the vivity lenses based on the comments at the time from Shannon Wongs u-tube channel. I got them in the understanding there would be some contrast loss, and halos at night to a small extent, but I would gain intermediate to quite near depth of focus. These tradeoffs seemed like the best combination for my personal preference. What I expected and what I now experience have given no surprises and have met expectations. I must say though that whether you see an improvement in your vision depends on what you are going from. In my case before the vivity, my night vision was bad. I could not see our black cat in the kitchen with the lights off or down low, but now I can. So to me, contrast greatly improved with the vivity. I can also read my cell phone no problem under most lighting, but I have to squint in a dark room. I have no problem whatsoever driving at night, and i can see the dashboard and distance clearly. I do see halos around traffic lights at night. Very small around red light, bigger around green or blue light, but it's minimal and you get used to it. It's the way things look now - and that's OK. You just get used to it - completely. Also I must say that I'm lucky enough to be reading 20/15 now after laser astigmatism correction during surgery. So am I happy with the outcome. Hell yes !!! There are always going to be tradeoffs, pick what's right for your case.

In traumatic cataracts is mandatory to expects diferent situations.

It would be a good idea to check the retroillumination mode of the microscope again.

How long will it take for the red reflex to return? For the dye to disintegrate in the vitreous?

Unintentional staining of anterior vitreus with trypan blue ( zonulopathy)

You could also paint the dye on the anterior capsule under OVD. That way you get it exactly where you want it and it doesn’t go in the vitreous cavity.

? Posterior ZD

1:24

I hope this is stable enough long term 🙏🏽 3 piece Optic Capture would have been better perhaps?

i think you have to lower the vitreus pressure in this cases somehow. You can engage with insuline canula and a little tap or a little vitrectomy will do the job

The lateral separation, required or not, probably caused more zonular loss. Early use of CTR or hooks could’ve helped, but sometimes you can’t avoid it.

It happened last month. I have the same problem with denser cataract . Converted into MSICS... PMMA lens with the haptic at the week area....minimum I/A...NO VITREOUS ...smooth recovery.

the capsular hooks saved this case, but perhaps a CTR right after rhexis wpuld have supported the phaco part with no need for hooks

MSICS would have been better here?

What a wonderful surgery. Thank you so much for sharing this video with your comments. Would it be better to do the bang technique after cataract surgery to prevent bleeding or would you also do it first?

Hyper mature morgagnian cataract !! Ends well due to great surgical skills. But I would rather play safe -enlarge the rhexis and insert the CTR before phaco.

Rhexis was too small! Don't do baby rhexis in hard cataract!

Now this is one of the more interesting parts of a youtube spiral

One of the greatest videos I ever watched, what a dedication🤗🤗

One of the greatest videos I ever watched, what a dedication🤗🤗

Myopic shift is usually bigger than the other eye so I usually shoot for +3ish in a 3 years old You can't be very accurate in these eyes but you can fix it later, as long as you avoid amblyopia

Does it affect the IOL power calculation ??? , since it probably affects the final position of the IOL

Its like driving, isn't it? Instinct. We dint think of accelerator, brake or clutch. It's muscle memory and second nature. ❤️

Suture suture suture

Why not a bag-in-lens iol ? Just asking