Tense eyball during SICS Posted By Dr. Sasikumar S Date : 09-Feb-01
I did Small incision cataract surgery on a 70 yr old lady today. The surgery was done under peribulbar anaesthesia.
There was good hypotony. A 4mm scleral tunnel incision was made with two radial cuts backwards. CCC was done and hydrodissection done. After hydrodelineation the eye ball became very tense. Cortical aspiration was difficult because of the tense eyeball. While apsirating the subincisional cortex through the paracentesis the pc ruptured. An automated vitrectomy was done and a 6mm x 12.5 mm single piece all PMMA IOL was implanted in the sulcus as there was good capsule support. After the vitrectomy the eye ball was soft.
I had similar experiences in a couple of cases earlier. What could be the reason for it? I presume it may be due to some fluid seeping behind the posterior capsule through the zonules during hydroprocedures especially if done beneath the iris. That may be the reason why the IOP came down after vitrectomy. In that case will it help if we do an aspiration of the fluid through the pars plana as in malignant glaucoma?
Has anybody got similar experiences?