Complications During and After Cataract Surgery: From Phacoemulsification Over Secondary IOL Implantation to Dropped Nucleus

Introduction
Contents
Abbreviations
Fundamentals for Complication Management
1 Basics
	Abstract
	1.1 Difficulty of Cataract Surgery in Relation to Density of Nucleus
	1.2 Difficulty of Cataract Surgery in Relation to Other Factors
	1.3 Anatomy of Different IOL Implantation Sites at the Slit Lamp
	1.4 Anatomic Requirements for an IOL Implantation
	1.5 1-piece IOL Versus 3-piece IOL
	1.6 Correct IOL Choice
2 Essential Surgical Techniques for Complication Management
	Abstract
	2.1 Surgical Technique: SICS, the Modified ECCE
	2.2 Trocar Surgery for Cataract Surgeons
	2.3 Get Acquainted with Your Surgical Equipment
	2.4 Summary
3 Planning for Surgical Complications
	Abstract
	3.1 Different Cases for Surgical Planning
Easy and Difficult Phacoemulsification
4 Phacoemulsification of an Easy Cataract
	Abstract
	4.1 Equipment
	4.2 Surgery of an Easy Cataract
5 Phacoemulsification of a Difficult Cataract
	Abstract
	5.1 How to Approach a Difficult Cataract
	5.2 Anaesthesia
	5.3 Instruments for a Difficult Phacoemulsification
	5.4 Problems During Side Incisions
	5.5 Problems During Main Incision
	5.6 Problems During Capsulorhexis
	5.7 Problems DURING Capsulorhexis
	5.8 Problems During Hydrodissection
	5.9 Problems During Phacoemulsification
		5.9.1 Posterior Capsule Rupture and Dropping Nucleus
	5.10 Problems During I/A—Implantation of Capsular Tension Ring
	5.11 Problems During Removal of Cortex
	5.12 Problems During IOL Implantation
	5.13 Problems During Final Steps
Complication Management with Trocar Cannulas
6 Anterior Vitrectomy and Other Surgeries with Trocars from Pars Plana
	Abstract
	6.1 Equipment for Surgery of Anterior Segment with Trocars
		6.1.1 Setup of Anterior Vitreous Cutter
	6.2 Surgical Setup for Trocar Surgery
	6.3 Settings for Anterior Vitrectomy with Phacoemulsification Machine
	6.4 Surgical Basics of Anterior Vitrectomy with Trocars
	6.5 Trocar Surgery with One Trocar
	6.6 Trocar Surgery with Two Trocars
	6.7 Anaesthesia
	6.8 The Surgical Technique of Insertion of Trocar Cannulas
		6.8.1 Anatomy of Pars Plana
		6.8.2 Insertion of Trocar Cannulas
7 How to Approach a Surgical Complication
	Abstract
8 Posterior Capsular Rupture
	Abstract
	8.1 Management of Posterior Capsule Rupture
	8.2 IOL Scaffolding for Residual Lens Pieces in Capsular Rupture (Agarwal Technique)
9 Surgical Management of Subluxated IOL from Pars Plana
	Abstract
10 Surgical Management of Dislocated Cortical Fragments
	Abstract
11 Surgical Management of Posterior Capsular Opacification from Pars Plana
	Abstract
12 Surgical Management of Positive Vitreous Pressure (PVP) During Cataract Surgery
	Abstract
	References
Surgical Techniques for Advanced Complication Management
13 Small Incision Cataract Surgery (SICS = Modified ECCE)
	Abstract
	13.1 Standard Instruments for SICS
	13.2 SICS Surgery
14 Surgical Management of Zonular Lysis
	Abstract
	14.1 Cataract Surgery with Zonular Lysis
	14.2 Zonular Lysis of 1 Quadrant
	14.3 Zonular Lysis of 1–2 Quadrants
	14.4 Zonular Lysis of 2–3 Quadrants: ICCE
IOL Extraction Techniques, Iris Capture and Capsular Phimosis
15 Extraction of an Acrylic IOL Through Cutting of IOL
	Abstract
16 Extraction of an Acrylic IOL Through IOL Refolding
	Abstract
17 Extraction of a Silicone IOL Through Bi-secting of IOL
	Abstract
18 IOL Explantation with Intraocular Rolling
	Abstract
19 Iris Capture by the IOL Optic
	Abstract
20 Peeling of Fibrosis in Capsular Phimosis
	Abstract
Secondary IOL Implantation Techniques
21 IOL Implantation in the Sulcus
	Abstract
	21.1 Introduction
	21.2 Correct IOL Choice
	21.3 Anaesthesia
	21.4 Sulcus Implantation with Intact Anterior Capsule
	21.5 Sulcus Implantation with Defect Anterior Capsule
22 Iris-Claw IOL Implantation
	Abstract
	22.1 Special Instruments for Iris-Claw IOL Implantation
	22.2 Iris-Claw IOL Implantation Surgery
	22.3 Complications
	22.4 FAQ
23 Intrascleral IOL Implantation (Scharioth Technique)
	Abstract
	23.1 Standard Instruments for Intrascleral IOL Implantation
	23.2 Intrascleral IOL Implantation Surgery
24 Intrascleral IOL Fixation with Flanged Haptics (Yamane Technique)
	Abstract
25 Scleral IOL Fixation
	Abstract
26 Scleral Fixation of Dislocated IOL In-The-Bag (Hoffmann Technique)
	Abstract
27 Fixation of IOL with Iris Suture
	Abstract
	27.1 Suturing an IOL to the Iris
	27.2 Suturing an IOL-Capsular Bag Complex to Iris
	27.3 Intra- and Postoperative Complications
Advanced Complication Management of Posterior Segment Using a Phacoemulsification Machine
28 Introduction and Possible Indications for Trocar Surgery of Posterior Segment
	Abstract
	28.1 Checklist for Trocar Surgery of Posterior Segment
	28.2 Possible Indications for Trocar Surgery of Posterior Segment
	28.3 Anatomy of Pars Plana Vitrectomy
	28.4 Surgical Set-Up
	28.5 Equipment for Trocar Surgery of Posterior Segment
		28.5.1 Devices
		28.5.2 Instruments
	References
29 Intraocular Pressure During Vitrectomy—Clinical Assessment and Surgical Action
	Abstract
30 Surgical Management of a Dropping and Dropped Nucleus
	Abstract
	30.1 Recovery of a Dropping Nucleus from Pars Plana
	30.2 Operative Planning and Strategies for Surgical Management of Dropped Nucleus
	30.3 Extraction of a Posteriorly Dislocated Soft Nucleus with Vitreous Cutter
	30.4 Extraction of a Posteriorly Dislocated Hard Nucleus with Intravitreal Phacoemulsification
	References
Surgical Pearls of Ocular Trauma
31 Corneal Perforation
	Abstract
32 Traumatic Cataract
	Abstract
33 Traumatic Mydriasis
	Abstract
34 Iridodialysis
	Abstract
	34.1 Iris Defect
35 Surgical Management of a Traumatic Aniridia and Aphakia with Iris and IOL Prosthesis
	Abstract
	35.1 Fixation of a 3-Piece IOL in a Foldable Iris Prosthesis (Human Optics®) and Implantation of Combo IOL–Iris Prosthesis Through a 2.4 mm Incision
36 Corneal, Lens and Retinal Perforation with a Nail
	Abstract
Materials and Companies
List of All Pits and Pearls
Index
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