Chang offers pearls for phaco with zonulopathy
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WAIKOLOA, Hawaii — David F. Chang, MD, offered pearls for phacoemulsification in cases of zonulopathy at Hawaiian Eye 2022.
First, avoid a small continuous curvilinear capsulorrhexis.
“If you don’t have a capsular tension ring, I like a three-piece lens because you get some compressive force from the haptics,” Chang said.
The second pearl is to use capsule retractors.
“To me, it’s as important as using dye for white cataract or expansion devices for a really tiny pupil. It solves one problem, which is intraocular fixation,” Chang said. “I tend to do this much earlier now, after I do the rhexis.”
Finally, use a dispersive viscoelastic to balloon up the bag.
“You have to realize that what’s different in these cases is that you don’t have centrifugal stretch on the posterior capsule,” Chang said. “That normal stretch is missing, so the capsule is much more pliant.”
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Chang DF. Phaco with zonulopathy: My top 3 pearls. Presented at: Hawaiian Eye 2022; Jan. 15-21, 2022; Waikoloa, Hawaii.
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