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What is Extra capsular extraction of lens is not possible in: and explain in detail?
Ans: C (Lens subluxation) Ref: www.eiournalofophthalmology.com/ejo/ejo18.htmlv; BASAK Essentials of Ophthalmology,5th edition, pg no 254,260Explanation:ECCE - It involves the excision of the central part of the anterior capsule Followed by the expression of the nucleus & placement of the IOL in the remaining capsular bag.Capsule with zonules should be intact so the IOL placed will be in pupillary axis.ICCE - The whole crystalline lens including the capsule is removed.Subluxated lens:Partially displaced lens still remaining in the pupillary region.Causes:Familial ectopia lentisEctopia lentis et papillaeAniridiaMarfan's syndrome Homocystinuria Weill marchesani syndromeManagement of subluxated lens:Zonular dialysis < 90 degrees - Capsular tension ring with ECCE90 - 270 degrees - Modified CTR with loops with ECCE> 270degrees - ICCE & anterior vitrectomy with ACIOL. iris fixated IOL or sclera fixated IOLCapsular tension ring: Fine PMMA made ring which is placed within the capsular hag to give support to the zonules thereby preventing the decenteration of the IOL.