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In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 ?m and aspirated via the Vitesse vitrectomy system. The same probe performs the vitrectomy and the nucleus removal. The postoperative period was uneventful with clear cornea, normal fundus, and 20/20 best-corrected visual acuity (BCVA). The hypersonic vitrectomy utilizes the ultrasound power of 29.5 kHz and a stoke length of 0 to 60 ?m for liquefaction of the vitreous. It can be a safe alternative for vitrectomy and lens removal in a single setting.
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AIM: To observe the clinical outcomes of femtosecond laser-assisted cataract phacoemulsification combined with anterior vitrectomy in the treatment of pediatric cataracts.METHODS: Retrospective study. A total of 10 patients(17 eyes)diagnosed as pediatric cataract in Foshan Aier Eye Hospital from January 2021 to September 2022 were collected, including 5 males(9 eyes)and 5 females(8 eyes), with an age of 3～9(4.50±1.20)years old. All children underwent femtosecond laser assisted phacoemulsification combined with anterior vitrectomy. The visual acuity, intraocular pressure and pigment deposits of intraocular lens(IOL)surface, synechia and hyperplasia of posterior capsule lens at 1wk, 1 and 6mo postoperatively were observed during the 6mo follow-up.RESULTS: All surgical procedures were successful, and there was no serious complication intraoperatively or postoperatively. BCVA(LogMAR)was 0.63±0.18 preoperatively and 0.42±0.10, 0.32±0.09, and 0.22±0.08 at 1wk, 1 and 6mo postoperatively(all P<0.001). There was no difference in the comparison of intraocular pressure at different times of surgery(P=0.125). There was no statistically significant difference in the incidence of IOL surface pigment deposits, synechia, and posterior capsule lens hyperplasia at different times after surgery(P>0.05). The incidence of IOL surface pigment deposits at 1wk, 1 and 6mo after surgery was 3 eyes(18%), 1 eye(6%), and 1 eye(6%), respectively, the incidence of synechia was 0 eye, 1 eye(6%), 2 eyes(12%), and the incidence of posterior capsule lens hyperplasia was 0 eye, 0 eye, and 2 eyes(12%), respectively.CONCLUSION: Femtosecond laser-assisted cataract phacoemulsification combined with vitrectomy for the removal of the anterior vitreous can effectively prevent anterior capsular tear and the occurrence of posterior capsule opacification.
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@#AIM: To observe the safety and efficacy of the 25G anterior vitrectomy surgical technique <i>via</i> scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber.<p>METHODS: This retrospective case review consisted of 18 eyes of 18 patients(8 males and 10 females), of those, 11 eyes had acute angle-closure glaucoma with angle-closure greater than 180 degree, and 7 eyes had lens subluxation combined with glaucoma. All 18 patients underwent phacoemulsification, intraocular lens(IOL)implantation, trabeculectomy, and anterior vitrectomy <i>via</i> the scleral flap in cases where conservative management techniques cannot control intraocular pressure(IOP). The main outcomes were best corrected visual acuity(BCVA), anterior chamber depth(ACD), IOP, slit-lamp microscopic examination, number of medications, fundus examination, and complications.<p>RESULTS: The average axial length(AL)was 21.5±0.6 mm. Mean age was 62.3±7.9 years. Mean ACD increased significantly from 0.78±0.43 mm to 2.89±0.41 mm 1wk after surgery(<i>P</i><0.001). Mean IOP decreased significantly from 43.28±9.38 mmHg to 16.72±6.28 mmHg(<i>P</i><0.001). No serious complications, such as endophthalmitis, retinal detachment, suprachoroidal hemorrhage, corneal decompensation, and malignant glaucoma were observed.<p>CONCLUSION: 25G anterior vitrectomy <i>via</i> scleral flap is a safe and effective technique for glaucoma and cataract with extremely shallow anterior chamber.
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@#AIM: To observe the safety and efficacy of the 25G anterior vitrectomy surgical technique <i>via</i> scleral flap in phacoemulsification combined with trabeculectomy for glaucoma and cataract with extremely shallow anterior chamber.<p>METHODS: This retrospective case review consisted of 18 eyes of 18 patients(8 males and 10 females), of those, 11 eyes had acute angle-closure glaucoma with angle-closure greater than 180 degree, and 7 eyes had lens subluxation combined with glaucoma. All 18 patients underwent phacoemulsification, intraocular lens(IOL)implantation, trabeculectomy, and anterior vitrectomy <i>via</i> the scleral flap in cases where conservative management techniques cannot control intraocular pressure(IOP). The main outcomes were best corrected visual acuity(BCVA), anterior chamber depth(ACD), IOP, slit-lamp microscopic examination, number of medications, fundus examination, and complications.<p>RESULTS: The average axial length(AL)was 21.5±0.6 mm. Mean age was 62.3±7.9 years. Mean ACD increased significantly from 0.78±0.43 mm to 2.89±0.41 mm 1wk after surgery(<i>P</i><0.001). Mean IOP decreased significantly from 43.28±9.38 mmHg to 16.72±6.28 mmHg(<i>P</i><0.001). No serious complications, such as endophthalmitis, retinal detachment, suprachoroidal hemorrhage, corneal decompensation, and malignant glaucoma were observed.<p>CONCLUSION: 25G anterior vitrectomy <i>via</i> scleral flap is a safe and effective technique for glaucoma and cataract with extremely shallow anterior chamber.
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Purpose: This study evaluated bimanual intracapsular irrigation-aspiration for ectopia lentis with use of a small incision for 4-point scleral fixation of a foldable posterior-chamber intraocular lens (IOL) and anterior vitrectomy in patients with Marfan syndrome. Methods: We performed a retrospective study of 18 eyes from 10 patients with Marfan syndrome who underwent surgical intervention for ectopia lentis at our clinic between July 2012 and September 2018. In this study, intraoperative and postoperative complications, uncorrected visual acuity, best-corrected visual acuity, spherical equivalent, intraocular pressure, and endothelial cell density were evaluated. Results: No intraoperative complications were reported. In all cases, early postoperative evaluation revealed a clear cornea, round pupil, and well-centered IOL. Mean logMAR uncorrected visual acuity improved from 1.09 preoperatively to 0.56 postoperatively (P < 0.05). Mean logMAR best-corrected visual acuity improved from 0.45 preoperatively to 0.17 postoperatively (P < 0.05). Aside from transient ocular hypertension, no postoperative complications were reported. Conclusion: The combined surgical technique presented above yields excellent visual outcomes with an extremely low incidence of complications. This approach is simple, safe, and effective in the treatment of ectopia lentis in patients with Marfan syndrome.
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Purpose: To report a series of central retinal artery occlusions (CRAO) following cataract surgery complicated by posterior capsular rupture (PCR). Methods: Data from 14 patients with acute CRAO following cataract surgery was collected for this study including subject demographics, initial and final best-corrected visual acuity, systemic investigations, optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) findings. Results: Mean subject age was 59.9 ± 12.1 years. Male: Female ratio was 1:1. All patients were operated between October and November 2015 and presented with acute vision loss 1 to 4 days after surgery. All the patients underwent cataract surgery under peribulbar anesthesia and had PCR for which anterior vitrectomy (AV) was done. In all the cases Ethylene oxide (ETO) sterilized vitrectomy probe was used for AV. Clinical picture of CRAO was noted in all the cases during the immediate postoperative period. OCT showed inner retinal layer hyperreflectivity while FFA was normal in all the cases. The final visual acuity was poor in all the eyes. This paper discusses the possible mechanisms of CRAO in these cases. Conclusion: CRAO is a potential complication of peribulbar anesthesia for intraocular surgery in patients with vascular risk factors and hence any substance that can aggravate the vasospasm in such patients should be used cautiously. Vasospasm could be caused by ETO as residual ETO could be present in the vitrectomy machine tubing causing toxicity. It is recommended to be cautious while using ETO sterilized instruments for cataract surgery.
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OBJECTIVES: To compare long-term postoperative complications of pediatric cataract surgery with primary intraocular lens (IOL) implantation associated with posterior capsulotomy (PC) and anterior vitrectomy (AV) between patients treated with a corneal or pars plicata/pars plana approach. METHODS: Children who underwent cataract surgery with in-the-bag primary IOL implantation were divided into two groups according to PC and AV surgical approach: a corneal approach (group 1) and a pars plicata/pars plana approach (group 2). Only patients with a follow-up duration of more than two years were included. Long-term surgical outcomes were retrospectively reported. RESULTS: The mean follow-up period was 10.00±3.13 years. No cases of glaucoma or retinal detachment were reported. The mean age at surgery was 34.57±22.66 months. Forty-six children were included (27 eyes in group 1 and 29 eyes in group 2). The most frequent postoperative complication was corectopia, followed by visual axis opacification. Both complications occurred more frequently in group 1 (p<0.001). After cataract surgery, the rate of additional surgeries in group 1 was 51.9%, while in group 2, the rate was 27.6% (p=0.1132). CONCLUSION: The pars plicata/pars plana approach with PC and vitrectomy with primary in-the-bag IOL implantation for pediatric cataracts is a safe procedure.
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Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cataract/congenital , Cataract Extraction/methods , Lens Implantation, Intraocular/methods , Postoperative Complications , Vitrectomy , Cataract Extraction/adverse effects , Retrospective Studies , Follow-Up Studies , Lens Implantation, Intraocular/adverse effects , Posterior CapsulotomyABSTRACT
Objective: To analyze the curative effect of phacoemulsification and to intraocular lens implantation combined with anterior vitrectomy in the children with congenital cataract, and to investigate its effectiveness and security. Methods: A total of 43 cases (49 eyes) of 3-7 years old congenital cataract children who were admitted to our hospital were selected as the subjects. According to different treatment methods, the children were divided into control group (23 cases with 26 eyes) and treatment group (20 cases with 23 eyes). The children in control group were treated with phacoemulsification and intraocular lens implantation and the children in treatment group were treated with phacoemulsification, intraocular lens implantation and anterior vitrectomy. After operation, the vision of the children in two groups was observed; the intraocular pressure (IOP), anterior chamber depth, posterior capsule turbidity and the complications in operation and after operation of the children in two groups were detected by non-contact tonometer and ultrasonic biological microscope. Results: The children in two groups were followed up for an average of 12 months after surgery, and 49 eyes were follow-up after operation. Compared with control group, the vision of the children in treatment group was improved significantly, and the constituent ratio of the children with corrected visual acuity after opertion≥O. 5 was significantly increased (P0. 05). Conclusion: Phacoemulsification and intraocular lens implantation combined with anterior vitrectomy in the children with congenital cataract can effectively improve the visual acuity, anterior chamber depth and posterior capsule opacity; it is more helpful for the reconstruction of visual function after operation in the children.
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Objective To investigate the effectiveness and safety of anterior vitrectomy combined with capsular retractor and Cionni modified capsular tension ring (MCTR) in traumatic lens subluxation surgery with anterior vitreous prolapse.Methods This study comprised 16 patients (16 eyes) of traumatic lens subluxation with anterior vitreous prolapse,in which iridodialysis was in 3 eyes,express implantation in 1 eye and Ahmed glaucoma valve implantation in 1 eye.According to the severity of lens subluxation,the patients were divided into three levels,including 90°-120° (7 eyes),120°-180° (5 eyes) and 180°-270° (4 eyes).Considering the anterior vitreous prolapse,anterior vitrectomy or/and pars plan vitrectomy was conducted with assistance of triamcinolone acetonide.After continuous curvilinear capsulorhexis,two to four capsular retractors were placed in the capsulorhexis to support and center the capsule.MCTR was inserted with scleral suture fixation after phacoemulsification.At last,the foldable IOL was implanted to capsular bag.Postoperative visual acuity,intra-and post-operative complications,anterior capsular opening,IOL positions and intraocular pressure (IOP) were assessed during 3 months' follow up.Results All patients had successfully undergone phacoemulsification,MCTR insertion and IOL implantation.Seven eyes were inserted with 2-eyelet MCTR and nine eyes were inserted with 1-eyelet MCTR.The postoperative visual acuity was better than 0.5 in 9 eyes,between 0.3 and 0.5 in 4 eyes,between 0.1 and 0.3 in 2 eyes,and less than 0.1 in 1 eye.Compared with pre-operation,the difference in the visual acuity was statistically significant (x2 =17.503,P =0.000).The scheimpflug images obtained from the Pentacam,which demonstrated that the IOL was well centered,and no MCTR and IOL decentration occurred.The common intraand post-operative complications were residual cortex,aqueous misdirection syndrome,anterior capsular tears,anterior capsular phimosis and posterior capsular opacification.Conclusion The effective application of anterior vitrectomy is the key point to reduce surgical complications.Anterior vitrectomy combined with insertion of capsular retractor and MCTR is an ideal surgical option for patients of traumatic lens subluxation with anterior vitreous prolapse.
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@#AIM: To evaluate the efficacy and safety of triamcinolone acetonide(TA)injected in anterior chamber during traumatic cataract surgery.<p>METHODS: From January 2013 to May 2016, 31 cases(31 eyes)of traumatic cataract were involved in our study. To identify whether there was vitreous loss and confirm the location of vitreous body, all the cases were injected TA into the anterior chamber respectively in surgery. Totally 13 cases(13 eyes)with intact posterior lens capsules were performed the small incision non-phacoemulsification cataract surgery. The others, 18 cases(18 eyes)with posterior capsule rupture and vitreous loss were performed with the anterior vitrectomy combined with small incision non-phacoemulsification cataract surgery. The follow-up time was for 6-12mo. <p>RESULTS: Tirty-one cases were completed the operation successfully. All the cases with second-stage penetrating corneal trauma were implanted intraocular lens(IOL). The other cases with first-stage penetrating corneal trauma were not implanted IOL. Eighteen cases, which were confirmed with posterior capsule rupture and vitreous loss by injecting TA into the anterior chamber,were consistently improved the visualization of vitreous cortex and treated with anterior vitrectomy successfully. During follow-up, 28 cases had best corrected visual acuity of more than 4.5. The postoperative inflammation of all cases was slight. There was no hard corneal edema and abiding intraocular pressure higher more than 1wk. The position of the pupil and IOL was normal. <p>CONCLUSION: Anterior chamber injection of TA can make the treatment of posterior capsule rupture and vitreous loss easier, and improve the safety of the traumatic cataract surgery. At the same time, it also can inhibit the postoperative inflammatory reaction.
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@#AIM: To investigate the influence factors of phacoemulsification combined with anterior vitrectomy for treating malignant glaucoma.<p>METHODS: Totally 23 cases(25 eyes)of malignant glaucoma patients, who were in-patient in ophthalmology of Wuhan Tongji Hospital from June 2011 to June 2016, underwent phacoemulsification combined with anterior vitrectomy, were involved in this study. The intraocular pressure and related ocular anatomy parameter change and its correlation were analyzed pre-and post-operatively. <p>RESULTS: There were 15 cases(16 eyes), average 51±6.7 years old, had deepened anterior chamber and intraocular pressure within the normal range(reffered as effective)post-operatively, in the other 8 cases(9 eyes), average 45±7.8 years old, postoperative anterior chamber formation were poor(referred as ineffective). Surgery effective rate was 64%. As for the effective group, the postoperative anterior chamber depth(2.13±0.82mm), significantly deepened compared with preoperative(0.76±0.53mm), and postoperative intraocular pressure(15.4±4.5mmHg)significantly declined compared with preoperative(26.4±8.7mmHg). The effective group had larger preoperative scleral spur distance and ocular axial length than ineffective group, 11.25±0.39mm <i>vs</i> 10.86±0.49mm and 22.16±1.16mm <i>vs</i> 20.98±0.62mm respectively, and the difference was statistically significant(<i>P</i><0.05). Age and the ocular axial length were statistically significant between effective and ineffective group by using single factor analysis results(<i>P</i><0.05). By logistic regression analysis, age and ocular axial length were independent risk factors for poor postoperative treatment effect(<i>P</i><0.05).<p>CONCLUSION: The younger age and the ocular axial length is risk factors for poor postoperative treatment effect of malignant glaucoma by phacoemulsification combined with anterior vitrectomy.
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Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV) were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA), early and late postoperative complications and intraocular pressure (IOP). Ultrasound biomicroscopic (UBM) evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT) was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow‑up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR]) and CDVA (logMAR) was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061) and the mean CMT at 2 years was 192.5 ± 5.54 μm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8%) case and postoperative uveitis was seen in 2 (5.7%) cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.
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?AlM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis ( PCCC ) combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery. ?METHODS:Postoperative clinical follow-up data of 82 cases ( 87 eyes ) with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group ( 38 cases, 40 eyes, recieved phacoemulsification + PCCC ) and the study group ( 44 cases, 47 eyes, accepted phacoemulsification+ PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow - up. lntraoperative and postoperative complications were observed. ?RESULTS:The rate of central optic axis opaque grade 0 in control group was 37. 5%, compared to 76. 6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group (P0. 5 in control group was lower than the 40 eyes ( 85. 11%) of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up ( P ?CONCLUSlON: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.
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AlM: To compare the clinical effects of two different surgical ways on congenital cataract. METHODS: We selected 52 children ( 84 eyes ) with congenital cataract surgery between December 2009 and December 2012 in our hospital. They were divided into two groups based on the surgical way: A group were treated by phacoemulsification + posterior curvilinear capsulorhexis, B group were treated by phacoemulsification+posterior curvilinear capsulorhexis+anterior vitrectomy. The follow-up was 6-12mo, and postoperative corrected visual acuity and complications were observed. RESULTS: Postoperative visual acuity of two groups were increased ( P0. 05 ) , while postoperative visual acuity between two groups had significant difference (P CONCLUSlON: Compare with phacoemulsification +posterior curvilinear capsulorhexis, the way combined with anterior vitrectomy can improve the postoperative visual acuity and decrease the incidence rate of PCO.
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PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
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Humans , Anterior Chamber , Aqueous Humor , Blister , Glaucoma, Open-Angle , Intraocular Pressure , Iridectomy , Prolapse , Trabeculectomy , VitrectomyABSTRACT
PURPOSE: To report the results of anterior vitrectomy for obstruction of the aqueous outflow shunt by prolapsed vitreous strands after trabeculectomy. CASE SUMMARY: Trabeculectomy was performed on a pseudophakic primary open angle glaucoma patient with uncontrolled intraocular pressure under maximum tolerable medical therapy. Three months after trabeculectomy, the bleb flattened and the intraocular pressure elevated. On gonioscopic examination, vitreous strands prolapsed through the iridectomy site obstructing the inner ostium. The maximum tolerable medical therapy and Nd:YAG laser vitreolysis were attempted, but the intraocular pressure was not controlled. Anterior vitrectomy was performed to remove the prolapsed vitreous strands. After anterior vitrectomy, the bleb regained filtering function and the intraocular pressure was stabilized. CONCLUSIONS: In a case with a prolapsed vitreous into the anterior chamber obstructing the outflow shunt of the aqueous humor after trabeculectomy, anterior vitrectomy showed therapeutic effects.
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Humans , Anterior Chamber , Aqueous Humor , Blister , Glaucoma, Open-Angle , Intraocular Pressure , Iridectomy , Prolapse , Trabeculectomy , VitrectomyABSTRACT
Objective To study the effect of double capsulorhexis combined with anterior vitrectomy in children with congenital cataract.Methods 42 (71 eyes) (age from 3 months to 14 years) underwent posterior continuous circular capsulorhexis (PCCC) and anterior vitrectomy after cataract extraction, and intraocularlens (IOL) were implanted in some eyes.The median follow-up time was 24 months.Results Among the 61 eyes of 37 patients who could do the visual examination,39 eye shada corrected visual acutiy of 0.5 or better, 16 eyes had a corrected visual acutiy of 0.3 or better;6 eyes had a corrected visual acuity of 0.3 or below.The postoperative complications included uveitis in 9 eyes,cornealede main 8 eyes,posterior capsular opacity(PCO) in 5 eyes.Some severe complications such as off centre IOL,cystoid macularedema and retinal detachment did not occur.Conclusion The double capsulorhexis combined with anterior vitrectomy and IOL implanted into eye should be a safe and effective method to prohibit after cataract in children with congenital cataract.
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PURPOSE: To investigate the general clinical features of congenital cataracts and to determine their relationship to visual prognosis and surgical complications according to age at operation and surgical procedure adopted. METHOD: We retrospectively evaluated 92 eyes in 61 patients with congenital cataracts who underwent cataract surgery between January 1996 and December 2006. The demographic data, surgical technique, post-operative complications, and final visual prognosis were evaluated. RESULTS: The average age at surgery was 3.17 years (range 1 month to 11 years), and the mean follow-up was 40.02 months (range 6 to 46 months). Of the 56 eyes that could be checked for visual acuity after cataract extraction, 29 (51.7%) had a BCVA of > or =0.5 at last visit. Unilateral congenital cataracts (p=0.025) and congenital cataracts with strabismus (p=0.019) showed significantly poorer visual outcomes. Patients with nystagmus also experienced a poor visual outcome; 6 patients (67%) had a BCVA of <0.1. Posterior cataracts had the worst visual prognosis (p=0.004). No statistically significant differences in posterior capsular opacity (p=0.901) or synechia formation (p=0.449) were observed between surgical techniques, but children younger than one year showed a higher tendency for PCO and synechia formation. CONCLUSIONS: Anterior vitrectomy did not reduce postoperative complications. Higher rates of complications (PCO, posterior synechia) developed in children younger than one year of age.
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Child , Child, Preschool , Female , Humans , Infant , Male , Capsulorhexis/methods , Cataract/classification , Cataract Extraction/methods , Follow-Up Studies , Lens Implantation, Intraocular , Nystagmus, Pathologic/complications , Postoperative Complications , Prognosis , Retrospective Studies , Strabismus/complications , Vision Disorders/rehabilitation , Visual Acuity/physiology , VitrectomyABSTRACT
PURPOSE: This study was conducted to assess the surgical outcomes of limbal lensectomy with or without anterior vitrectomy for the management of lens subluxation. MATERIALS AND METHODS: The medical records of 20 consecutive patients (33 eyes) with lens subluxation who had undergone limbal lensectomy with or without anterior vitrectomy from February 1999 to January 2004 were retrospectively reviewed. RESULTS: All the patients, except one high axial myopic patient, were implanted with scleral sutured posterior chamber intraocular lens. We evaluated the preoperative, postoperative visual acuity and postoperative complications and compared the results in group I (limbal lensectomy with anterior vitrectomy, 27 eyes) to those in group II (limbal lensectomy without anterior vitrectomy, 6 eyes). The preoperative best-corrected visual acuity was 0.21 and postoperative best-corrected visual acuity was improved by 2 lines or more in all 27 eyes in group I, and in 5 eyes in group II (p>0.05). The most frequent postoperative complication was intraocular lens dislocation in four eyes (14.8%) in group I alone. No retinal detachment occurred in either group, even in patients with high myopia. CONCLUSION: Limbal lensectomy without anterior vitrectomy improved visual acuity similarly to limbal lensectomy with anterior vitrectomy without significant increase of postoperative complications. This results of this study suggest that anterior vitrectomy is not necessarily required for the management of lens subluxation.
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Humans , Joint Dislocations , Lens Subluxation , Lenses, Intraocular , Medical Records , Myopia , Postoperative Complications , Retinal Detachment , Retrospective Studies , Visual Acuity , VitrectomyABSTRACT
This study evaluated the surgical outcome of various surgical technique in paediatric cataract implant surgery, at Jakarta Eye Center, Jakarta, Indonesia. This was a retrospective study of 57 eyes in 44 children who had primary cataract implants surgery. Three surgical techniques used were : 1. Extracapsular cataract extraction with intraocular lens implantation with intact posterior capsule which was performed on 21 eyes (group 1). 2. Extracapsular cataract extraction with intraocular lens implantation and posterior capsulorhexis (PCCC) and optic capture which was performed on 24 eyes (group 2). 3. Extracapsular cataract extraction with intraocular lens implantation, posterior capsulorhexis and anterior vitrectomy which was performed on 24 eyes (group 3). All patients were followed up more than one year. Our results showed that posterior capsule opacity (PCO) was developed in 20 eyes with intact capsules in group 1. All eyes had a clear visual axis in group 2. PCO developed only in one eye in group 3. In conclusion, PCCC and optic capture with or without anterior vitrectomy are effective methods in preventing PCO in infant and children.