Phacoemulsification with perfluorocarbon liquid using a 23-gauge transconjunctival sutureless vitrectomy for the management of dislocated crystalline lenses

Abstract

We describe the modified technique of phacoemulsification in dislocated crystalline lenses. After the vitreous and posterior hyaloid membrane were removed using a 23-gauge three-port vitrectomy, perfluorocarbon liquid (PFCL) was injected at the posterior pole in order to fill the vitreous cavity. The dislocated lens floated on the PFCL, and the injection was ceased once the lens had risen to the iris plane. The lens was then removed from the anterior chamber using standard phacoemulsification procedures. During the phacoemulsification, the PFCL provides a support underneath the nucleus, like a trampoline, and even small fragments can be completely removed. The final best-corrected visual outcome was more than 20/40 in 11 eyes. Although two eyes showed LP(-) due to optic neuropathy, those eyes showed a remission in inflammation and an increase in IOP. This modified use of PFCL in the removal of dislocated lenses fragments may overcome the limitation of earlier management of dislocated lenses.