Fakodonezisi ve zonüler diyalizi olan hastada lens ön kapsülünün, iris kancaları ile kapsüloreksis kenarlarındankorneaya asılmasının fakoemulsifikasyon cerrahisine etkisini bildirmeyi amaçladık. Sol gözde katarakt, fakodonezis ve 180 derece zonül kaybı olan hastaya beş adet iris germe kancası kapsüloreksis sınırından lens ön kapsülüne takıldı. Bu kancalar gerilerek lens korneaya asıldı. Sabit hale gelen lense kapsül germe halkası takılıp fakoemulsifikasyon cerrahisi uygulandı. Cerrahi sonrasında zonül kaybında artış olmadığı tespit edildi Hasta afak bırakıldı. Cerrahiden on beş gün sonra lensin bir bacağı zonül diyalizinin olmadığı sağlam sulkus bölgesine yerleştirilirken diğer bacak ise yeterli kapsül desteğinin olmamasından dolayı irise sütüre edildi. Sonuç olarak, fakodonezisli ve/veya zonül desteği zayıf olan olgularda lensi, iris germe kancaları ile ön kapsülden korneaya sabitlemenin yararlı olduğu kanısındayız
It was aimed to report the beneficial effects of using iris retractor hooks to suspend anterior lens capsule to the cornea in a patient with phacodonesis and zonular dialysis on phacoemulsification surgery. Five iris hooks were inserted to suspend the anterior lens capsule in a patient with traumatic cataract, phacodonesis, and 180 degrees zonular dialysis in the left eye. Phacoemulsification was performed after the lens was made stable with a capsular tension ring. The patient did not receive an intraocular lens. No enlargement in zonular dialysis was observed following surgery compared to the preoperative examination. A secondary lens implantation was performed two weeks after surgery. The lens was inserted with one haptic in the sulcus and the other haptic was sutured to the iris due to lack of capsular support. We suggest that stabilizing the lens by suspending the anterior capsule to the cornea with iris retractor hooks is a safe method for phacoemulsification surgery in patients with phacodonesis and zonular dialysis
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1. Kinacaid MC. Pathology of the Lens. In: Tasman W, editor. Duane's clinical ophthalmology. Philadelphia: Lippincott Williams & Wilkins 2005.
2. Groessl SA, Anderson CJ: Capsular tension ring in a patient with WeillMarchesani syndrome. J Cataract Refract Surg 24:1164-5,1998.
3. Gimbel HV, Sun R, Heston JP. Management of zonular dialysis in phacoemulsification and IOL implantation using the capsular tension ring. Ophthalmic Surg Lasers 28:273- 81. 1997.
4. Liu Y, Wu M: Clinical use of capsular tension ring during phacoemulsification in subluxated lens. Zhonghua Yan Ke Za Zhi 38:262–4, 2002.
5. Bayraktar S, Altan T, Kucuksumer Y, Yilmaz OF. Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome. Intraoperative complications and early postoperative findings. J Cataract Refract Surg 27:1620–8, 2001.
6. Santoro S, Sannace C, Cascella MC, Lavermicocca N. Subluxated lens: phacoemulsification with iris hooks. J Cataract Refract Surg 29:2269-73, 2003.
7. Novak J. Flexible iris hooks for phacoemulsification. J Cataract Refract Surg 23:828-31, 1997.