Viscoelastic helps protect weak zonules

When a surgeon notices weak or disrupted zonules in a patient’s eye during cataract surgery, he or she must learn to stop and reassess the situation before continuing with the procedure in order to minimize the chances of further damage, according to one surgeon.

Although there are currently several options available to surgeons for treatment of damaged zonules, they are not reliable in every case, said Robert M. Mandelkorn, MD.

Options include suturing the lens capsule to the sclera, using iris hooks to stabilize the capsular bag during surgery or implanting a capsular tension ring; however, these solutions can sometimes cause further damage, Dr. Mandelkorn said. In the event of damaged zonules during cataract surgery, the eye should be filled with a high molecular weight viscoelastic.

“The surgeon will find the layer of viscoelastic substance has protected the anterior vitreous face. The wound can then be safely closed, and the surgeon can then decide whether to implant an anterior chamber lens or suture a posterior lens into the eye,” he said.

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