SquintMaster.Com

15/06/2023

Today I did squint surgery on this young girl. Pre-operative image (left side) and post-operative image on right. This surgery was done on moving eyes under Topical anesthesia (without general or local anesthesia). The patient and her parents we so happy that I can express it in words. It took 2 hours of my surgical time but it was worth spending to make someone smile; that is our job.

31/05/2023

Squint Surgery Under Topical Anesthesia In A 17 Year Child Unedited (HD)

Case 2: Squint (Strabismus ) Surgery On The Moving Eyes under Topical Anesthesia https://www.youtube.com/watch?v=G4cwL3h0DRcCase 1. Squint Surgery Under Topi...

17/09/2022

This young man had right eye lateral re**us palsy following a fatal road traffic accident. He was referred to us. He had a paralytic convergent squint, which is very difficult to treat per se.
We took this challenge and did augment the Hummelsheim procedure (Superior Re**us Muscle and Inferior Re**us Muscle Transposition) combined with medial re**us muscle recession.
It took my 2 hours of operating time. The result was very rewarding for the patient, his family, and the surgeon

25/08/2022

E Video BooK
White Intumescent Cataract Management: My Approach
ISBN: 9798201376215
The intumescent white cataract poses challenges during many different steps of surgery.
The primary issue is the pressure created within the capsular bag due to the liquified cortex material. If the anterior chamber pressure is lower than the intralenticular pressure, there will be a forward force exerted on the anterior capsule during capsulorrhexis creation. This will rapidly cause an uncontrolled radialization of the capsulorrhexis, which can extend to the posterior capsule, leading to a dropped nucleus and vitreous prolapse. The key to managing this is to keep the anterior chamber pressure higher than the intralenticular pressure during capsulorrhexis creation.

two small paracentesis incisions are created, each being less than 1 mm in width. This small size is important to pressurize the anterior chamber after the anterior capsule has been stained with trypan blue dye. We avoid making the primary phaco incision at this point because it is much larger, about 2 mm to 3 mm in width. This large incision will depressurize the anterior chamber, and the intralenticular pressure will be too high in comparison. Via the small paracentesis, a 25-gauge bent needle cystotome is used to create a small, round capsular opening. This round configuration is important because it will not radialize or rip uncontrollably. At this point we can make the main phaco incision with a diamond keratome and insert the phaco probe. Through this small capsular opening, the probe is used to aspirate out the fluid from the capsular bag. Touching the nucleus and rocking it gently will ensure that any fluid behind the nucleus also is aspirated.
With the intralenticular fluid removed, the pressure in the capsular bag is very low, and we can now create our larger 5-mm diameter capsulorrhexis without fear of inducing the Argentinian flag sign, which occurs with a radially split capsule that gives the blue-white-blue appearance of that flag. With successful completion of the 5-mm capsulorrhexis, the nucleus can be removed using the phaco-chop technique (Figure 2). With the dense nucleus, a mechanical disassembly of the nucleus using the chop technique can reduce the ultrasonic energy and help preserve corneal endothelial cells. The lens implant is inserted into the capsular bag, and the case is completed without issues.
https://books2read.com/u/bPgVpY

25/08/2022

E Video Book
Posterior Polar Cataract Management: My Approach
ISBN: 9798201084349
Introduction
Posterior polar cataracts (PPC) are cataracts lying on the posterior pole of the lens. They are stuck to the posterior capsule, so there are many times more chances of the post capsule ruptures and related sequelae. In this E Video book, I am going to share my approach.
Pre-operative considerations and plans
1. Patient Counseling: Patient counseling is very important and it requires substantial chair time with a patient and relative to explain the complexities of the disease, procedure, and chances of re-surgeries in writing.
2. Anesthesia and Akinesia: My preferred choice is peribulbar local anesthesia with good akinesia.
3. Capsulorhexis Size: I prefer moderate size central capsulorhexis
4. Hydro Procedures: I prefer hydro delineation and gentle hydro dissection. Many surgeons do not advise doing hydro dissection. I found the hydro-dissection in the posterior capsular cataracts very useful as it separates the epinucleus from the posterior capsule in the most natural way. The hydro delineation in posterior cataracts is also very beneficial as it separates the nucleus from the epinucleus. Fine et al.40 used minimal hydro dissection and hydro delineation, nuclear emulsification from within the epinuclear shell, and gentle viscodissection of the epinucleus and cortex to avoid unnecessary pressure on the posterior capsule and to protect the region of the greatest potential weakness throughout the procedure4.
5. Intraocular Lens: If the posterior capsule remains intact then any hydrophobic lens if I have planned phacoemulsification. Poly methyl methacrylate (PMMA) intraocular lens for manual small incision cataract surgery (MSICS) and posterior capsule rupture with intact anterior capsulorhexis. In the case of the medium, large posterior capsule rent (PCR) and the sulcus, my preferred lens is PMMA IOL.
6. Always keep your vitrectomy machine on standby
Management

https://books2read.com/u/mg7axX

25/08/2022

E Video Book
Cataract And Small Pupil Management Manual Techniques
ISBN: 9798201201784
In this book, we are going to discuss various manual techniques of small pupil management. The details of the cases are as follows:
Case1: Nuclear cataract grade 4 with small pupil
Case 2: Nuclear cataract grade 4 with floppy iris with small pupil
Case 3: Morgagnian cataract with a calcified capsule with weak zonules with small pupil
Case 4: Post uveitis Complicated cataract with rigid small pupil
Case 5: Post trabeculectomy Complicated cataract with rigid small pupil
Case 6: Complicated cataract with 1 mm small pupil
https://books2read.com/u/bz1zxE