Surgery for Steroid Implant-Induced Cataract | Complex Anterior Segment Surgery at University of Michigan Kellogg Eye Center
Steroid implants are sometimes used to treat swelling in the retina. In this case, the patient had undergone placement of a steroid implant for retinal swelling, but upon referral to Kellogg, the implant was noted to be in the natural lens of the eye, inducing a cataract.
Cataract surgery in this context can be challenging, since the natural capsule surrounding the lens has been opened and may not provide adequate support to the cataractous lens material.
Here, Dr. Nambi Nallasamy (cornea and anterior segment surgeon at University of Michigan Kellogg Eye Center) performs cataract surgery to remove the steroid implant-induced cataract. A few techniques were employed to help safely remove the lens material. First, no hydrodissection was performed in order to avoid expanding the prior opening in the lens capsule. Second, hydrodelineation was performed to allow the nucleus of the lens to spin, making removal easier. Third, a manual dissection of the anterior cortex was performed in lieu of hydrodissection. Fourth, the nucleus of the lens was “bowled out” using the phacoemulsification handpiece to remove as much nuclear material as possible prior to placing any stress on the lens capsule. With these techniques, the cataract was safely removed and no complicating factors were encountered despite the pre-existing opening in the lens capsule.
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