DR. MANEESH BAPAYE

Abstract

Microspherophakia is an autosomal recessive condition characterized by increased anteroposterior diameter and reduced equatorial diameter. It is associated with systemic conditons like weill-Marchesani syndrome etc. Whole lens is visible on complete mydriasis. We present a case of 34 years old male patient who had dense nuclear sclerosis along with microspherophakia. He underwent phacoemulsifiction with pars plana vitrectomy and glued IOL. Intraop challenges faced were very bulky nucleus in a small capsular bag making nuclear rotation difficult. This was overcome by debulking the nucleus with vitrectomy cutter. Vertical chop could be easily performed. Capsular bag removed with cutter, Pars plana vitrectomy was done. Three piece IOL was implanted in sulcus by externalizing haptics under the preplaced scleral flaps. Majority of patients undergo surgery when lens is still soft. This video displays technique for phaco in dense nuclear sclerosis with microspherophakia.