Abstract
Objective:To evaluate the characteristics, safety and effectiveness of a modified technique of phacoemulsification in post-vitrectomy cataracts.Methods:This retrospective clinical trial comprised 31 patients (31 eyes) with post-vitrectomy cataract, who had undergone phacoemulsification combined with intraocular lens implantation. An alternative surgical technique known as phacoemulsification in the anterior chamber was used for nucleus management in those cases. The following parameters were evaluated: best corrected visual acuity (BCVA), ocular inflammation, intraocular pressure, endothelial cell count and surgical complications.Results:Three months after surgery, the BCVA improved significantly compared with that before surgery (Z=-10.547; p<0.05). There were no significant differences in IOP before and after surgery (Z=-0.474; p>0.05). There was a statistically significant postoperative decrease in endothelial cell densities (Z=-3.916; p<0.05). The mean endothelial cell loss was -8.71%. A little inflammatory response in the anterior chamber in 11 eyes and mild corneal edema in 8 eyes were observed on the first day after surgery, which subsided after a week. The posterior capsular opacification were observed in three eyes, two of which were denser, and the YAG laser was performed for posterior capsular incision. No obvious surgical complications occurred.Conclusion:The modified technique of phacoemulsification, with phacoemulsification in the anterior chamber, is safe and effective to deal with post-vitrectomy cataracts.
Highlights
With the advancement of technology, modern vitrectomy has greatly improved the prognosis of patients with vitreous retinopathy
Subjects: We retrospectively analyzed 31 patients (31 eyes) with post-vitrectomy cataract from January 2016 to May 2017 in Jinan Second People’s Hospital, Jinan Eye Hospital
The plaques had been removed by posterior capsular polishing in six eyes, but the very dense plaques had been managed by posterior capsulorhexis in the other eyes
Summary
With the advancement of technology, modern vitrectomy has greatly improved the prognosis of patients with vitreous retinopathy. The occurrence of post-vitrectomy cataracts can affect the patient’s vision, as well as the observation and treatment of the fundus.[1] The preferred method of surgery to correct post-vitrectomy cataract is phacoemulsification and intraocular lens implantation.[2,3]. The conventional method of this surgery is to perform phacoemulsification inside the lens capsular bag.[2] This surgery itself has many challenging features caused by the intraocular structural changes after vitrectomy, such as the small pupil, flabby suspensory ligament, fragile posterior capsule, and more mobility of the. Pak J Med Sci November - December 2018 Vol 34 No 6 www.pjms.com.pk 1512 posterior capsule, which increase the difficulty and risk of the surgery.[4,5] In this study, we improved the traditional technique of nuclear emulsification by performing phacoemulsification outside the capsule in order to minimize surgical difficulty and help reduce complications
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