Video Presentation - VT5

TWO BATTLES, ONE VICTORY

A 50-year-old one eyed male with NS3-4 cataract, pseudoexfoliation glaucoma, and ischemic CRVO underwent cataract surgery with planned anti-VEGF injection. Intraoperative zonular dialysis necessitated capsular tension ring (CTR) placement. However, posterior capsular rupture led to the dislocation of both the CTR and a three-piece IOL into the vitreous. A three-port pars plana vitrectomy was performed. The CTR was retrieved via a side port using a bimanual technique. The same dislocated IOL was then successfully scleral-fixated using the Max-NIT technique at 3 and 9 o’clock positions. Endolaser and intravitreal anti-VEGF were administered. This case underscores the value of timely vitreoretinal intervention and surgical adaptability in managing two complications—zonular instability, dropped IOL and CTR ring—in a high-risk, one-eyed CRVO patient.