How do we manage a PCR intraop?

• Maintain a normotensive globe and prevent anterior chamber collapse

• Compartmentalize the lens and vitreous with an OVD

• Avoid intraoperative vitreous traction

• Attempt removal of lens fragments only if they are visible and easily accessible

• After using tricot, using either a bimanual limbal or pars plana approach, perform an anterior vitrectomy until no vitreous is seen anterior to the capsule

• Insert an IOL only when safe and indicated— preferably a posterior chamber lens placed in the ciliary sulcus or fixated to iris or sclera, or an anterior chamber lens with prophylactic peripheral iridectomy

• Adjust the lens power appropriately for the position and type of IOL used

• Perform a watertight incision closure and remove the OVD

• If posteriorly dislocated lens fragments are present, arrange a prompt referral to a vitreoretinal surgeon for removal

• Disclose and discuss all surgical complications with the patient

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