Mmmhhh....I once had a patient develop endophthalmitis after sequential bilateral Intravitreal antivegf injection. I know its not the same thing. I remember that patient to date because he moved from 6/18 both eyes to NPL both eyes within a week.
@@UdayDevgan True, so did this eye shift in myopia from the index of refraction change? Central white cataracts usually had some large changes in myopia.
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Dr Weinstock’s fellow here. Works on all cataract cases. You have to be cognizant of your power when grooving hard ones so as to not cause a wound burn, basically giving it a little pause with no phaco every couple seconds or so.
I had my left eye done last Wednesday, today is Monday and my vision so much better now it’s amazing,next week my right eye, can’t wait but it’s 2 weeks.
Uday, While I agree with your approach on the role of RLE in correcting anisometropia (especially at the age of 60), I'd also consider ICL in presbyopes in those with sufficient ACD (usually not an issue in high myopes). Not only does it provide vision correction, preserves future IOL options and importantly much lower retinal risk than RLE. We've had great success with it in those without lens changes in pts up to low-mid 50's. Great video as always!
ICL is approved for ages 18 to 45 for a good reason. Crystalline lens increases in anterior-posterior dimension with age and increasing cataract development.
I wouldn't attempt it until I have over a 100 consecutive cases without a single subpar chop. But then my total case count is less than a 100 at this point.
Interesting case. I would be worried about interlenticular opacification (ILO) as we noted in past when placing both acrylic piggyback lenses in the bag for high hyperopes. I just saw an exhyperope with a dense ILO with 2 MA30 in the bag. In general I think piggybacking is most safe long term when one IOL is in the bag and the other is in the 3:44 sulcus. Typically with one made of silicone and the other of acrylic. This alternative configuration presumably makes it harder for the epithelial cells to find their way between the lenses as they can when both IOLs are in the bag. Hopefully in this case this will not be a problem. Thank you for sharing these interesting cases.
Wow, I haven’t listened to the podcast yet, but I was always taught with piggyback IOL’s or when using 2 lenses, avoid using the same material for the second lens to avoid uncorrectable haze/pseudomembrane glistening between the IOL’s that is only fixed with explanting one lens and replacing it with a silicone lens on top of the acrylic lens. This is even with the updated acrylic lenses by Alcon too, I would still think about using a silicone lens as the second lens not only to prevent the haze/glistening but also to reduce incidence of positive dysphotopsias. Interesting! Thank you for sharing!
We can also try Putting in air bubble at end , which will tamponade the lower lip of incision and hydration for the roof , this does the job most of the times
