Characteristics and effects of surgery treatment for complicated cataract in silicone oil filled eyes

Abstract

Objective To analyze the characteristics of complicated cataract of silicone oil tamponade eyes after pars plana vitrectomy, and to evaluate the effects of phacoemulsification and its relative factors. Methods Data of 51 eyes of 47 patients who underwent the treatment of phacoemusification for complicated cataract after silicone oil tamponade were analyzed. Twenty-eight patients were males (28 eyes), and 19 were females (23 eyes). The average age was (55.45±11.37) years old with a range from 22 to 75 years old. The protopathy of all patients with silicon oil tamponade eyes included rhegmatogenous retinal detachment in 11 patients (11 eyes), macular hole induced by high myopia in 3 patients (3 eyes), PDR in 27 patients (31 eyes), retinal vein occlusion in 4 patients (4 eyes), and penetrating ocular injury in 2 patients (2 eyes). The preoperative best corrected visual acuity (BCVA) ranged from light perception to 0.25. The preoperative intraocular pressure (IOP) was (16.87±5.29) mmHg (13.0~41.0 mmHg). The corneal endothelial cell counts was (2632.8±402.9)/mm2 (845~3448/mm2). The follow-up was (4.71±1.12) months with a range from 3 to 6 months. Results The lens in silicon oil tamponade eyes was characterized by nuclear opacity with little posterior cortex adhered tightly to the posterior capsule. The postoperative BCVA ranged from light perception to 0.6. BCVA increased in 47 eyes, remained stable in 3 eyes, and decreased in 1 eye. The postoperative IOP was (14.82±2.56) mmHg with a range from 11.0 to 24.0 mmHg (1 mmHg=0.133 kPa), and decreased compared with preoperative one (P<0.05). The postoperative corneal endothelial cell counts was (1926.89±449.91)/mm2 (608~2850/mm2), and decreased compared with preoperative one (P<0.05). The intraoperative and postoperative complications mainly included posterior capsule rupture (1 eye), temporary IOP elevation (5 eyes), various degrees of corneal edema (all 51 eyes), various degrees of aqueous flare (29 eyes), anterior chamber blood cells (1 eye), and papillary zone fibrin exudation (1 eye). Conclusion Complicated cataract of silicone oil tamponade eyes is characterized by nuclear opacity with little posterior cortex adhered tightly to the posterior capsule. Higher vacuum and lower energy should be highlighted in phacoemulsification surgery, and it should be a caution to protect the posterior capsule. Phacoemulsification is a safe and effective method for the treatment of complicated cataract in silicone oil tamponade eyes. Key words: Silicon oil; Cataract, complicated; Phacoemulsification