Severe traumatic cataract dislocation, atonic pupil and glaucoma

A case for the ages… bungee cord injury to eye…traumatic severely dislocated cataract, barely hanging with maybe literally 1-2 zonules (ligaments) intact, vitreous prolapse, atonic fixed dilated pupil, and glaucoma with very high pressure of 50mmHg! Managed with vitrectomy, anterior levitation of lens using microforceps assisted with scleral depression, iris hooks to hold edge of rhexis during capsular opening, two of my capsular tension segments sutured to sclera with GoreTex and capsular tension ring, phaco, then Intraocular lens in capsular bag. Then pupil sutured with 10-0 Prolene iris cerclage and finally placement of an Ahmed Glaucoma Valve. Local topical/subTenons anesthesia, while talking to my patient and teaching to medical traineees… 1.5 hours.