1. ARAVIND EYE CARE SYSTEMS PC Rent with Nucleus / IOL Drop Sr.Panchavarnam

2. ARAVIND EYE CARE SYSTEMS The whole or partial nucleus drop into the vitreous Definition:

3. ARAVIND EYE CARE SYSTEMS OccurrenceOccurrence 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

4. ARAVIND EYE CARE SYSTEMS Signs of nucleus drop AC deep – Anterior chamber will be deep Difficulty in delivering nucleus with Sinske –suspect impending PCR Nucleus drop

5. ARAVIND EYE CARE SYSTEMS ManagementManagement 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 problem patients.

6. ARAVIND EYE CARE SYSTEMS Complications (Post Operative) Retinal Detachment Chordial detachment Vitreous Haemorrhage Aphakic Glaucoma or Pseudo Aphakic Glaucoma Inflammation

7. ARAVIND EYE CARE SYSTEMS IOL Drop During the cataract surgery if the implanted lens drops into the vitreous the condition is called as IOL drop

8. ARAVIND EYE CARE SYSTEMS ReasonsReasons Posterior capsule rent IOL dialing Zonular dialysis

9. ARAVIND EYE CARE SYSTEMS ManagementManagement 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.

10. ARAVIND EYE CARE SYSTEMS