Escolar Documentos
Profissional Documentos
Cultura Documentos
163
OPHTHALMIC
S U R G E R Y
Introduction
Subluxation of lens signifies partial displacement of
crystalline lens or cataractous lens from its central
position in the pupillary area.
2.
3.
Iridolenticular gap.
4.
5.
Focal iridodonesis.
Etiology
Subluxation of lens may be congenital or acquired.
Congenital subluxation of lens can occur as an isolated
anomaly or associated with heritable disorders. The
acquired subluxation of lens may occur due to
hypermaturity of cataract, trauma, stretching, pull and
degeneration of the zonule 1,2,3,4.
Signs of Zonular damage should be sought in every
patient especially if there is history of ocular trauma
or pseudo-exfoliation (PXF).
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3.
4.
Preoperative evaluation
a)
i.
ii.
iii.
iv.
Management
1.
Progressive subluxation.
2.
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165
2.
3.
4.
5.
6.
7.
8.
9.
b.
166
2.
3.
4.
a.
5.
a.
b.
2.
3.
a.
b.
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167
b)
168
June 2009
169
Table 1: Indications of capsular tension ring, modified-capsular tension ring and capsular tension segment
CTR
Requires continuous curvilinear capsulorhexis
May be placed prior to lens removal
M-CTR
CTS
Yes
Yes
No
With difficulty
With difficulty
Yes
No
No
Yes
No
No
Yes
No
Yes
Yes
( multiple segments)
No
Yes
Yes
No
Yes
Yes
No
No
Yes
Yes
Yes
No
CTR: capsular tension ring, M-CTR: modified-capsular tension ring, CTS: capsular tension segment
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9.
10.
11.
12.
13.
14.
15.
16.
17.
References
1.
18.
2.
19.
3.
20.
4.
21.
5.
22.
6.
7.
23.
8.
24.