Abstract

Purpose To assess the visual and refractive outcome of immediate intraoperative vitrectomy and intrascleral intraocular lens implantation using a “standardized” sutureless Yamane technique during cataract luxation in the vitreous chamber as a complication of phacoemulsification. Design A prospective, interventional, consecutive case series. Materials and Methods Twelve patients underwent vitrectomy and intrascleral intraocular lens fixation using a standardized Yamane technique as the primary procedure during complicated phacoemulsification. Patients were evaluated preoperatively and 6 months postoperatively for best-corrected distance visual acuity, correspondence to the preoperative refractive target in the spherical equivalent, endothelial cell count, and complications. Results Mean preoperative best-corrected visual acuity was 1.16 ± 0.3 logarithm of the minimum angle of resolution (logMAR), the endothelial cell count was 1910.5 ± 297.64, and target refraction at baseline was −0.197 ± 0.087. Postoperatively, best-corrected visual acuity was significantly improved; the mean value was 0.05 logMAR ± 0.06. Mean baseline target refraction in the spherical equivalent was −0.20 ± −0.09 (range: −0.08 to −0.37), and mean final refraction was −0.44 ± −0.14 (range: −0.25 to −0.75) with no significant difference (p=0.87). No complication was registered intra- and postoperatively. Conclusion Standardization of the Yamane technique seemed a valuable option for patients who had complicated phacoemulsification to achieve a predictable refractive outcome. Synopsis. The predictable refractive outcome could be achieved with the immediate standardized Yamane technique in patients with intraoperative cataract luxation in the vitreous chamber during phacoemulsification.

Highlights

  • To assess the visual and refractive outcome of immediate intraoperative vitrectomy and intrascleral intraocular lens implantation using a “standardized” sutureless Yamane technique during cataract luxation in the vitreous chamber as a complication of phacoemulsification

  • Synopsis. e predictable refractive outcome could be achieved with the immediate standardized Yamane technique in patients with intraoperative cataract luxation in the vitreous chamber during phacoemulsification

  • Since it is difficult to insert the haptics into the scleral tunnel using this approach, scleral fixation of the intraocular lens (IOL) haptics is a significant issue [6,7,8,9,10,11]. e technique is often poorly standardized in terms of tunnel construction, position of the opposite tunnel, and length of the portion of the haptic that requires cauterization

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Summary

Research Article

Gianluca Besozzi ,1 Chiara Posarelli, Maria Carmela Costa, Alessio Montericcio ,3 Giuseppe Nitti, Ermete Giancipoli, Milena L’Abbate, Francesco Pignatelli, Barbara Parolini, and Michele Figus. To assess the visual and refractive outcome of immediate intraoperative vitrectomy and intrascleral intraocular lens implantation using a “standardized” sutureless Yamane technique during cataract luxation in the vitreous chamber as a complication of phacoemulsification. Twelve patients underwent vitrectomy and intrascleral intraocular lens fixation using a standardized Yamane technique as the primary procedure during complicated phacoemulsification. E predictable refractive outcome could be achieved with the immediate standardized Yamane technique in patients with intraoperative cataract luxation in the vitreous chamber during phacoemulsification. After cataract luxation in the vitreous chamber, a single experienced surgeon (GB) performed a standard 23 g three-port PPV (Constellation, Alcon, USA) with cataract fragment removal with core vitrectomy, posterior hyaloidectomy, peripheral vitreous shaving without indentation, anterior hyaloidectomy, removal of residual capsular and zonular remnants and scleral fixation IOL implant with “standardized” Yamane’s technique, and peripheral retina check with indentation.

Results
Target refraction
Conclusion
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