Why Knot?? - Tackling Subluxated Cataract With Extreme Zonular Loss

To demonstrate a unique technique of in the bag IOL in a subluxated cataract with severe zonular loss with Marfan's syndrome.

In a tertiary eye care hospital, in Western India

This surgical video outlines the comprehensive
management of subluxated cataract in a 38-year-
old female with Marfan syndrome and near 360-
degree zonular weakness in both eyes. The
procedure includes capsulorhexis using forceps
stabilization of the capsular bag with capsular
hooks, phacoemulsification and the meticulous
implantation of a Cionni-modified capsule
tension ring. The Cionni ring is secured to the
sclera using Canabrava's technique, and the 6-0
prolene sutures are flanged intrasclerally. The
intraocular lens is then implanted into the
capsular bag. 

This minimally invasive technique
with a learning curve achieves optimal bag
centration while eliminating the need for
conjunctival peritomy and scleral fashioning flap,
pocket, or groove, offering a promising
alternative.