Little Fishtail For Trauma
Thomas A. Oetting, MS, MD
A nice job was done as the resident started the case with a perfect capsulorhexis and nice initial groove. We had noticed some zonular weakness that was consistent with the patient's history of blunt trauma years ago. When we tried to spin the lens, the nucleus decentered and tilted a bit.
{Comment from Dr. Brian Little, who developed this technique: "Personally I prefer to put the ring in as soon as I'm aware of any zonular deficiency as I think you then benefit from its support during fragmentation and removal of the lens, when you need it most... With the nucleus in place, expanding the subcapsular space with OVD before inserting the ring ensures that very little cortex is trapped by the ring. People get anxious about removing cortex trapped by the ring but it just needs some gentle side-to-side circumferential sweeping once you have hold of it with the aspiration cannula. It's really not the problem that some would have you believe." July 30, 2009.}
Additional Notes: length 3:28
