90 FILM FESTIVAL (FF2) FILM FESTIVAL – CATARACT COMPLICATIONS/CHALLENGING CASES TITLE PRODUCER FF2-01 Navigating Complexities: Phacoemulsification in silicone-oil filled eye Lorenz Jacob MANGAHAS Philippines This paper explores the challenges of performing cataract surgery in vitrectomized eyes filled with silicone oil and outlines strategies for achieving optimal outcomes. It describes key anatomical and physiological alterations such as a shallow anterior chamber, posterior capsule bowing, emulsified silicone oil, dense cataracts, synechiae, and poor pupil dilation. These changes increase surgical difficulty and the risk of complications, including posterior capsular rupture. The discussion emphasizes careful preoperative planning, awareness of altered intraocular dynamics, and readiness for intraoperative adjustments. Postoperative management may include YAG capsulotomy for residual plaques. Overall, successful cataract surgery in silicone oil-filled eyes requires specialized surgical techniques and comprehensive understanding of silicone oil’s impact on ocular anatomy and function. FF2-02 Complicated Cataract Surgery With Iridodialysis Fixation Jan Bond CHAN Malaysia A 26-year-old gentleman presented history of traumatic eye injury from a large rope while fixing a ship while he was working in Indonesia 1 week ago. He has vitreous in the anterior chamber, hyphema, iridodialysis from 2 o’clock to 10 o’clock area, cataractus lens, phacodonesis, vitreous hemorrhage, macula hole and high intraocular pressure at 35mmHg. He was started on antiglaucoma and his IOP reduced to 15mmHg and proceed with surgery. The video discusses tips and points regarding this complicated surgery. FF2-03 Phaco in Nystagmus Rahul BAILE India Doing Topical phaco sounds very easy, but when u get a patient who's heart has an ejection fraction of 20%, cardiologist has suggested not to use injection anaesthesia, and patient has congenital horizontal nystagmus with astigmatism, it's a nightmare to do Topical Phaco emulsification in such case. Doing reference marking on cornea and taking incisions, doing capsulorhexis, even a simple step of hydrodissection becomes difficult. Also when you see through microscope and patients eyes are constantly moving you yourself start getting vertigo and headache as you are not able to focus at any point on the eye. In the video I have shown how I managed to get the best surgical result in the above mentioned patient. FF2-04 Safe & Effective: Simplified phacomorphic & phacolytic glaucoma surgery for rural patients Ravikumar P. India Long standing Phacomorphic glaucoma is a challenging case for any expert surgeon, we planned the surgery with all pre-op care to reduce the IOP by all medications. With all the medical treatments, still the IOP is about 30 mm of Hg. We planned closed chamber procedure SICS with good wound construction, controlled capsulorhexis and performed a safe nucleus' delivery via the sandwich technique. We achieved good visual outcomes in all the patients. FF2-05 Tadanki Technique to Avoid Argentinian Flag Sign Ramakrishna TADANKI India Argentinian Flag sign is one of the most dreaded complications while handling a white intumescent cataract. There are many techniques described to avoid this like staged rhexis, spiral rhexis, phacopunch, automated decompression but none are 100 percent safe. My technique is one more in the armamentarium. The steps are: 1) AC entered with phaco handpiece in I/A mode. 2) High vacuum initiated. 3) Anterior Capsule punctured with sharp cystitome with left hand. The large bore of phaco handpiece instantly decompresses the capular bag thereby avoiding the Argentinian flag sign. FF2-06 Better Scaffolding Than Regret: A shield preventing rupture in complex cases Ryosuke SAKAI Japan Despite the remarkable evolution of modern phaco fluidics, anterior chamber stability alone cannot ensure the safety of high-risk eyes. Is there scope for surgical improvement beyond the machine? This film presents Proactive IOL Scaffolding, a vital technique that surgeons-in-training must master. Unlike standard rescue scaffolding, we demonstrate its prophylactic value in complicated cataracts. By creating a compartment in the chamber, the earlyimplanted IOL protects the posterior capsule from the occlusion break surge. Through various surgical cases, we demonstrate that this mechanical barrier significantly increases safety margins, teaching surgeons to proactively prevent complications rather than merely reacting to them.
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