Title : Dos and donts of lensectomy in microspherophakic subluxated lens for beginner pediatric surgeon in a 2 year old child
Abstract:
Purpose: To educate beginner surgeons on dos and don'ts of performing lensectomy in microspherophakic subluxated lenses in children
Setting/Venue: Pediatric Ophthalmology and Strabismus Department, Al-Shifa Trust Eye Hospital, Rawalpindi
Method: A 2-year-old child with bilateral microspherophakic subluxated lenses underwent lensectomy in right eye, and surgery was recorded for educational purposes. Lens was located in the pupillary plane with intact zonules. Two ports were created using an MVR blade. Low fluid rate was maintained to prevent pushing the lens posteriorly in to vitreous. Cutter was used to create a hole in anterior capsule which was then carefully maneuvered through the cortical matter until reaching the other end of the equator, where another hole was created for auto hydrodissection of cortical matter. During lens matter aspiration, caution was exercised to avoid capturing the capsule. Anterior vitrectomy was performed in the pupillary plane and anterior vitreous, followed by checking for vitreous attachments. Air was injected in anterior chamber before closing the ports. Air fluid exchange was done and ports were checked to ensure wounds are watertight. Each step explained with voice-over
Results: Surgical procedure was successfully performed by a beginner pediatric surgeon. The steps outlined were followed meticulously, resulting in safe removal of the subluxated lens without complications.
Conclusion: Lensectomy in microspherophakic subluxated lenses in children requires careful planning and execution. By following the outlined dos and don'ts, beginner surgeons can navigate the procedure safely and achieve favorable outcomes. Education through recorded surgeries are valuable resources for improving surgical skills.
