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SURGICAL TECHNIQUE
Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 897-899

Double crescentic edge separation for the management of cap-lenticular adhesion in small incision lenticule extraction


Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Prof. Jeewan S Titiyal
Cornea, Cataract and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1147_19

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We describe a modified technique of lenticule extraction for the management of cap-lenticular adhesions (CLAs). In cases where the lenticule edge could not be delineated, a Sinskey hook was introduced through the cap side-cut with the hook facing up (toward the cap), advanced to the periphery of lenticule at 3'o clock (for right-handed surgeons) and used to nudge the underside of the cap in the region of lenticule side-cut. The diagnosis of CLA was confirmed on observing a crescentic gap between the lenticule-side cut and the rolled lenticule edge. The gap was enlarged to create a crescentic area of separation spanning 2–3 clock hours. A similar crescentic area of separation was created on the opposite side (9'o clock). A microforceps was used to segmentally separate the lenticule from both edges toward the midline followed by lenticule extraction. Our technique was successfully applied in 11 cases of CLA with no complications.


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