Abstract
Purpose To evaluate the technique of vitreous tap using needle aspiration for management of anterior chamber shallowness during phacoemulsification. Methods A retrospective study included 26 eyes of 17 patients who underwent phacoemulsification in which vitreous tap was performed using a 27-gauge needle attached to a 5 ml syringe, inserted 3.5 mm from the limbus to aspirate 0.2 ml of liquefied vitreous if a cohesive (OVD) failed to sufficiently deepen the anterior chamber. Results Preoperative anterior chamber depth was 2.31 ± 0.26 mm, axial length was 21.7 ± 0.67 mm, lens thickness was 4.5 ± .19 mm, and cataract grade was 3.77 ± 1.4. Preoperative CDVA in LogMAR units was 0.98 ± 0.75. Coexisting angle closure glaucoma was present in 7 patients (26.92%) preoperatively. Vitreous needle tap was successful in vitreous removal on the first attempt in 26 eyes (100%). Postoperative follow-up period was 22.88 ± 10.24 (4–39) months. The final postoperative CDVA in LogMAR units was 0.07 ± 0.1, while the final postoperative IOP was 16.54 ± 1.45 mmHg. No complications related to vitreous tap were noted. Conclusion Vitreous needle tap is a simple, cost-effective, and safe technique for management of shallow anterior chamber in phacoemulsification.
Highlights
During phacoemulsification, shallow anterior chamber interferes with almost every step, starting from the creation of wound incisions and capsulorhexis till the intraocular lens implantation [1].Working in a narrow space inside the eye increases the risks of Descemet’s membrane detachment, capsulorhexis extension, and zonular dialysis
We report on the use of vitreous needle aspiration in cases of shallow anterior chamber during phacoemulsification to evaluate its safety and efficacy
Vitreous needle tap was successful in vitreous removal on the first attempt in 26 eyes (100%)
Summary
Shallow anterior chamber interferes with almost every step, starting from the creation of wound incisions and capsulorhexis till the intraocular lens implantation [1].Working in a narrow space inside the eye increases the risks of Descemet’s membrane detachment, capsulorhexis extension, and zonular dialysis. Shallow anterior chamber interferes with almost every step, starting from the creation of wound incisions and capsulorhexis till the intraocular lens implantation [1]. High-vitreous pressure in such eyes can result in iris prolapse or posterior capsular rupture with subsequent vitreous loss and possibly suprachoroidal haemorrhage. Postoperative intraocular pressure elevation, macular oedema, choroidal effusion, and malignant glaucoma develop more frequently in these eyes [1, 4,5,6]. Shallow anterior chamber is commonly seen in eyes with short-axial length. The term small eye is used to describe a spectrum of disorders characterized by shortaxial length [6]. Relative anterior microphthalmos is more common and characterized by normal axial length, small corneal diameter, and anterior segment [6, 10]
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