Author reply

Abstract

We thank Prof Thomas for his interest in our article. In the management of posterior capsule rupture and vitreous loss, visualization of the vitreous body is important for complete removal of the vitreous from the anterior chamber. Vitreous visualization is also useful to allow for minimally invasive surgical techniques to clear the vitreous, avoiding excessive surgical intervention during the management of posterior capsule rupture.Several techniques have been reported for visualization of the vitreous body in the anterior chamber, and they have pros and cons. Visualizing the vitreous body using triamcinolone1Burk S.E. Da Mata A.P. Snyder M.E. et al.Visualizing vitreous using Kenalog suspension.J Cataract Refract Surg. 2003; 29: 645-651Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar has a potential risk of postoperative steroid-related complications. We developed a technique of visualizing the vitreous body using 11-deoxycortisol, a precursor of cortisol devoid of steroid activities.2Kaji Y. Hiraoka T. Okamoto F. et al.Visualizing the vitreous body in the anterior chamber using 11-deoxycortisol after posterior capsule rupture in an animal model.Ophthalmology. 2004; 111: 1334-1339Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar, 3Kaji Y, Hiraoka T, Okamoto F, et al. Clinical application of 11-deoxycortisol in visualizing prolapsed vitreous body after posterior capsule rupture in cataract surgery. J Cataract Refract Surg. In press.Google Scholar A problem with the use of such pharmaceutical agents is that in some situations informed consent is needed, and in many countries around the world regulatory approval for the use of the drug may not be in place, so its use might be called, in some locales, off label, further raising the administrative complexities of the use of such agents. Considering this, utilizing the endoilluminator for visualization of the vitreous body in the anterior chamber is a favorable option for the management of posterior capsule rupture and vitreous loss. Conversely, clearer visualization of the vitreous strands using triamcinolone or 11-deoxycortisol can be advantageous and may reduce postoperative complications related to the prolapsed vitreous body. We thank Prof Thomas for his interest in our article. In the management of posterior capsule rupture and vitreous loss, visualization of the vitreous body is important for complete removal of the vitreous from the anterior chamber. Vitreous visualization is also useful to allow for minimally invasive surgical techniques to clear the vitreous, avoiding excessive surgical intervention during the management of posterior capsule rupture. Several techniques have been reported for visualization of the vitreous body in the anterior chamber, and they have pros and cons. Visualizing the vitreous body using triamcinolone1Burk S.E. Da Mata A.P. Snyder M.E. et al.Visualizing vitreous using Kenalog suspension.J Cataract Refract Surg. 2003; 29: 645-651Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar has a potential risk of postoperative steroid-related complications. We developed a technique of visualizing the vitreous body using 11-deoxycortisol, a precursor of cortisol devoid of steroid activities.2Kaji Y. Hiraoka T. Okamoto F. et al.Visualizing the vitreous body in the anterior chamber using 11-deoxycortisol after posterior capsule rupture in an animal model.Ophthalmology. 2004; 111: 1334-1339Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar, 3Kaji Y, Hiraoka T, Okamoto F, et al. Clinical application of 11-deoxycortisol in visualizing prolapsed vitreous body after posterior capsule rupture in cataract surgery. J Cataract Refract Surg. In press.Google Scholar A problem with the use of such pharmaceutical agents is that in some situations informed consent is needed, and in many countries around the world regulatory approval for the use of the drug may not be in place, so its use might be called, in some locales, off label, further raising the administrative complexities of the use of such agents. Considering this, utilizing the endoilluminator for visualization of the vitreous body in the anterior chamber is a favorable option for the management of posterior capsule rupture and vitreous loss. Conversely, clearer visualization of the vitreous strands using triamcinolone or 11-deoxycortisol can be advantageous and may reduce postoperative complications related to the prolapsed vitreous body. Visualizing the VitreousOphthalmologyVol. 112Issue 5PreviewKaji et al are to be congratulated on experimenting with a method of visualizing the vitreous body in the anterior chamber.1 They have attempted to improve on the method described earlier.2 Full-Text PDF