Zonular Dehiscence in a One-Eyed Patient

by Richard J. Mackool, M.D.

Phacoemulsification is performed in a one-eyed, high myope with posterior staphyloma and an axial length >30mm. Trypan Blue is used to stain the capsule. Zonular dehiscence with vitreous prolapse is discovered intra-operatively. Dr. Mackool moves from temporal to superior and creates a new phaco incision. The use of Viscoat® is discussed throughout the case as a tool to maintain the capsule and keep the vitreous from moving forward. After inserting a CTR, a 23 gauge, 2500cpm vitrectomy is performed and the patient is sent home aphakic until the following day when a refraction is performed and used to calculate the power of the IOL that is then inserted.

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©2014 Dr. Richard J. Mackool, MD

The machine settings, parameters, and techniques shown in these videos have been established by the surgeon.



Dr Richard Mackool is an internationally recognized expert in the field of ocular microsurgery. He is an inventor of numerous instruments and techniques for cataract removal and IOL designs, has published hundreds of papers and several textbooks, lectured throughout the world, and surgeons from every continent have travelled to New York to attend courses conducted by him. He has performed more than 50,000 ophthalmic procedures, specializing in cataract-implant surgery, corneal refractive and transplant surgery, and vitreous microsurgery. His widely-read monthly column, PhacoTips℠, appeared in Ocular Surgery News for 20 years.