25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical efficacy of 25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract.<p>METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared. <p>RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(<i>P</i>>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: <i>P</i><0.001; Group B: <i>P</i><0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(<i>P</i>=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(<i>P</i>=0.727, <i>P</i>=0.286, <i>P</i>=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: <i>P</i>=0.206, Group B: <i>P</i>=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: <i>P</i>=0.023, <i>P</i>=0.015, <i>P</i><0.01, Group B: <i>P</i>=0.018, <i>P</i><0.01, <i>P</i><0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: <i>P</i>=0.195, 12mo: <i>P</i>=0.313, 24mo: <i>P</i>=0.485, 36mo: <i>P</i>=0.089). The rate of postoperative complications was lower in Group A than Group B(<i>P</i>=0.042).<p>CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.

Peripheral iridectomy for preventing iris-related complications in glued intraocular lens surgery in children

Purpose: To assess the role of surgical peripheral iridectomy (PI) in preventing iris-related complications associated with glued intraocular lens (GIOL) surgery in children with bilateral ectopia lentis. Methods: Nonrandomized interventional case series of 34 eyes of 17 children (<15 years of age) who underwent pars plana lensectomy (PPL) and GIOL surgery between January 2013 and December 2016. Eyes with surgical PI (January 2013–June 2015) were compared with those without surgical PI (July 2015–December 2016). The primary outcome measure of the role of surgical PI in GIOL surgery was to account for complications such as optic capture, secondary glaucoma, intraocular lens (IOL) dislocation, or repeat surgery. The secondary outcomes were changes in the best-corrected visual acuity (BCVA). Results: The mean age at surgery was 8.8 years (range: 3.5–15 years). Surgical PI was conducted in 15 eyes. Among the 19 eyes without PI, 9 eyes had complications (optic capture –6; rise in IOP –4; IOL subluxation –4; repeat surgery –5). The complications were significantly less in the PI group, P = 0.02. There was a statistically significant improvement in BCVA (P = 0.0001) in all the patients. The mean presenting BCVA was 0.99 (±0.79) logMAR (Snellen ? 20/200) and post BCVA was 0.40 (±0.50) (Snellen ? 20/50). The mean preoperative refraction was ? 9 D (±8D) (range: ?5 D to ?23D) and postoperative was ?1 (±1.15) D. The mean follow-up was 25.4 months. Conclusion: Surgical PI along with GIOL surgery in children undergoing PPL is shown to reduce optic-capture-related complications.

Lensectomía refractiva en coloboma de iris / Refractive lensectomy for iris coloboma

RESUMEN El coloboma de iris es un defecto congénito, que se describe como un orificio, fisura o hendidura en dicha estructura.​ Esta condición tiene la posibilidad de ser hereditaria o aparecer sin historia familiar previa. Se presenta un caso de un paciente de 51 años de edad con coloboma bilateral de iris asimétrico e hipermetropía, quien acudió a la consulta médica con el deseo de independizarse de su corrección óptica habitual. Se propuso cirugía facorrefractiva de ambos ojos con pupiloplastia del ojo derecho, en el que se obtuvieron resultados visuales satisfactorios después de la intervención quirúrgica(AU)

ABSTRACT The iris coloboma is a congenital defect, present since birth, which is described as a hole, fissure or cleft in the mentioned structure. This condition has the possibility of being inherited or can appear without previous family history. The case is presented of a 51-year-old patient with bilateral asymmetric iris coloboma and farsightedness. The patient went to the doctor's office with the desire to become independent of his usual optical correction. Facorrefractive surgery of both eyes with pupilloplasty of the right eye was proposed, in which satisfactory visual results were obtained after the intervention(AU)

Visual recovery and complications after vitrectomy combined with phacoemulsification in PDR patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the visual recovery and complications in patients with proliferative diabetic retinopathy(PDR)after vitrectomy combined with phacoemulsification. <p>METHODS: According to different surgical methods, 95 cases(95 eyes)with PDR were divided into the observation group(50 cases)and the control group(45 cases). The observation group was treated with vitrectomy and phacoemulsification, while the control group was treated with vitrectomy and lensectomy. The visual recovery, changes of intraocular pressure before and after surgery and the complications were compared between the two groups. <p>RESULTS: The visual acuity of the two groups was significantly improved after surgery(<i>P</i><0.05), and the improvement in observation group was significantly greater than that in the control group(<i>P</i><0.05). The intraocular pressure of the two groups was increased significantly at 1, 3 and 6mo after surgery(<i>P</i><0.05), without significant difference between the two groups(<i>P</i>>0.05). The incidence of iris neovascularization and capsule opacification in the observation group(2%, 6%)were significantly lower than those in the control group(18%, 27%; <i>P</i><0.05). <p>CONCLUSION: Vitrectomy combined with phacoemulsification can obviously improve the visual acuity of patients with PDR, and the incidence of complications is low. Although it will lead to an increase in intraocular pressure, it can be improved after symptomatic treatment.

Application value of cataract extraction surgery in the treatment of primary angle-closure glaucoma and cataract / 中国基层医药

Objective To investigate the application value of cataract extraction surgery in the treatment of primary angle-closure glaucoma and cataract.Methods 132 patients of primary angle-closure glaucoma and cata-ract were randomly selected,these patients were divided into lensectomy treatment group(A group,n=66) and laser peripheral iridotomy treatment group(B group,n=66) according to the treatment method.The visual acuity,intraocu-lar pressure,anterior chamber depth,and complications of the two groups were analyzed statistically.Results In A group,the visual acuity 0.3-0.4 in 20 cases,>0.4 in 34 cases, accounting for 0.00%,18.18%,30.30%,51.52%.In B group,the visual acuity 0.3-0.4 in 19 cases,>0.4 in 28 cases,accounting for 7.58%,21.21%,28.79%,42.42%.A group of visual acuity 0.4 was significantly higher than B group(χ2 =7.38,P0.3-0.4 vision between the two groups were not significant(χ2 =2.71,4.61,all P>0.05). The differences of the intraocular pressure and anterior chamber depth before surgery between the two groups were not significant(t=1.532,1.447,all P>0.05),the anterior chamber depth after surgery in group A was significantly lon-ger than B group(t=2.571,P0.05).A group had corneal edema in 1 case,a transient high IOP in 4 cases,2 cases in hyphema,the postoperative complication rate was 10.61%.B group had corneal edema in 1 case,a transient high IOP in 4 cases, 2 cases in hyphema,the postoperative complication rate was 10.61%,the incidence rate of postoperative complica-tions in A group was significantly lower than B group(χ2 =9.35,P<0.05).Conclusion The application value of cataract extraction surgery in the treatment of primary angle -closure glaucoma and cataract is higher than laser peripheral iridotomy,which can more effectively improve visual acuity, prolong anterior chamber depth, reduce inci-dence of complications of patients,so it is more safe and effective,and worthy of promotion.

Lentes intraoculares plegables y astigmatismo posquirúrgico en la catarata pediátrica / Foldable intraocular lenses and postsurgical astigmatism in pediatric cataract

Objetivo: determinar el astigmatismo posquirúrgico en pacientes con diagnóstico de catarata pediátrica operados y con implante de lente intraocular plegable. Métodos: estudio observacional, descriptivo y transversal en 20 pacientes 28 ojos entre 2 y 14 años de edad, operados de enero de 2008 a septiembre de 2010 en el Instituto Cubano de Oftalmología Ramón Pando Ferrer. Se excluyeron los pacientes que presentaban alteraciones corneales. Se realizó lensectomía con capsulotomía posterior y vitrectomía anterior. Se implantó lente de acrílico hidrofóbico e hidrofílico plegable. Resultados: el 55 por ciento de los pacientes tenían entre 5 a 8 años de edad promedio 5,7 años. El tipo de catarata más frecuente fue la congénita 85 por ciento. La agudeza visual preoperatoria en el 60,7 por ciento de los casos era inferior a 0,3, a los 4 meses de operados 32,1 porciento tenían más de 0,9 y al año 35,7 por ciento alcanzó más de 0,9 y 28,6 por ciento entre 0,3 y 0,6. El astigmatismo antes de la cirugía en 32,2 por ciento estaba entre 0,5 y 1,5, a los 4 meses y al año fue entre 0,5 y 1,5 en 35,7 porciento. Conclusiones: el astigmatismo no sufrió variaciones con la realización de este tipo de cirugía. Una estrategia quirúrgica personalizada permite una mejor recuperación anatómica y funcional en estos pacientes

Objective: to determine the postsurgical astigmatism in patients operated on from pediatric cataract and with foldable intraocular lens implantation. Methods: an observational, descriptive and cross-sectional study of 20 patients 28 eyes between 2 and 14 years of age, who were operated on in the period of January 2008 through September 2010 at Ramon Pando Ferrer Cuban Institute of Ophthalmology. Some patients were excluded if they presented corneal alterations. Lensectomy, posterior capsulotomy and anterior vitrectomy were performed; hydrophobic and hydrophilic acrylic lenses were implanted. Results: fifty five percent of patients were 5 to 8 years of age average of 5.7 years. The more frequent type of cataract was the congenital 85percent. The initial visual acuity in 60.7 percent of cases was below 0.3; four months after surgery, 32.1 percent reached over 0.9 and after a year 35.7 percent reached more than 0.9, and 28.6 percent from 0.3 to 0.6. The astigmatism before the surgery in 32.2 percent of cases ranged 0.5 to 1.5, but four months and one year after surgery, it was 0.5 to 1.5 in 35.7 percent of patients. Conclusions: astigmatism did not vary with the performance of this type of surgery. A personalized surgical strategy allows achieving better anatomical and functional recovery of these patients

Comparative analysis of different surgery methods in treatment of proliferative diabetic retinopathy patients with cataract / 中国基层医药

ObjectiveTo compare the effects of two treatmnent methods in the treatment of proliferative diabetic retinopathy (PDR) patients with cataract.Methods79 PDR patients with cataract,according to the different surgical methods were divided into:phacoemulsification with lensectomy of 41 cases(52 eyes) in Group A and crystal resection with lensectomy of 38 cases(48 eyes) in Group B.The changes of eye pressure,iris neovascularization (INV),fundus fluorescein angiography were observed.ResultsThe visual acuity increased in 42cases (80.0％)postoperative in group A,which was significantly higher than that of group B [ 30 cases(62.5％ ) ] (x2 =4.26,P ＜ 0.05) ;The incidence of INN was 3.8 ％ in Group A,which was significantly lower than that of Group B (12.5％ )( x2=4.02,P ＜ 0.05 ) ;The macular edema and postoperative fundus fluorescein angiography showed no significant difference in two groups ( x2 =2.02,2.58,all P ＞ 0.05 ).ConclusionThe effect of phacoemulsification with vitrectomy for the treatment of PDR with cataract was superior to the posterior lens removal of vitrectomy surgery.

Preliminary result of trans pars planar vitreo-lensectomy combined with intraocular lens insertion in patients with ocular injury

Introduction: Cataract and vitreous opacification caused by ocular injury results in significant visual loss. Objectives: to evaluate the initial outcome of patients with ocular blunt or penetrating trauma who underwent trans pars planar vitreo-lensectomy and posterior chamber intra ocular lens insertion. Comment on the indications and applications of surgical techniques. Subjects and method: In this prospective randomized study, a total of 30 patients (30 eyes) with blunt/penetrating ocular trauma were assessed using X-ray and ultrasound in the Trauma Department of National Institute of Ophthalmology, from December 2005 to August 2006. Results: 30 patients (28 men and 2 women) with an age range from 3 to 45 years. Penetrating injuries are more common than blunt ones. The cornea is the most common site of injury (73.3%). Conclusion: Intraocular lens were implanted at the time of trans pars planar vitreo-lensectomy can provide a reasonable restoration of visual acuity and binocular function.

Limbal Lensectomy with or without Anterior Vitrectomy for the Management of Lens Subluxation / 영남의대학술지

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.

Application of a modified pars plana lensectomy within traumatic eyes / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate a surgical method of modified lensectomy within combined lensectomy and vitrectomy surgery in traumatic eyes.·METHODS: Clinical records were studied retrospectively for a series of consecutive 27 traumatic patients who were performed vitrectomy combined with lensectomy surgery. A modified lensectomy through pars plana incision of sclera was performed to these cases and lens capsule was reserved. It was then combined with vitreous and retinal operations.·RESULTS: All lens were removed completely with lens capsule remained. All cases achieved improved visual acuity.Intraocular pressure (IOP) in all eyes was in normal range after surgery.·CONCLUSION: The modified lensectomy is a safe and effective surgery manner which has few complications and is more suitable for traumatic eyes in the combined lensectomy and vitrectomy surgery.KEYWORDS:ocular trauma; lensectomy; vitrectomy

Preservation of anterior capsule during vitrectomy and lensectomy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the preservation of anterior capsule during vitrectomy and lensectomy.ment (RD) and grade C proliferative vitreoretinopathy (PVR)underwent pars plana vitrectomy (PPV) and pars plana lensectomy (PPL) with preservation and polishing of the anterior capsule. Of the 15 eyes, 4 eyes had giant tear, 3 had recurrent rhegmatogenous retinal detachment (RRD), 2 had diabetic retinopathy. Totally 6 eyes had gas and 9 had silicone oil tamponade. The surgeries were evaluated according to the visual acuity (VA) and the postoperative complications during the follow-up of at least 3 months.in all eyes, improved by 3± 3 lines overall. Eight eyes were implanted posterior chamber intraocular lens (PCIOL) successfully at 2-3 months after operation, including 6 having gas and 2 having silicone oil tamponade. No eyes had central anterior capsule opacity, corneal decompensation, puplillary block, retina redetachment or other complications.an intact anterior capsule in eyes with RD and PVR. Preserving the anterior capsule can help preventing intraoperative and postoperative complications of gas or silicone oil, simplify future PCIOL placement, and maintaining a normal iris appearance.

Long Term Results of the Lensectomy in Children with Ectopia Lentis

PURPOSE: To analyze the clinical features and the long term visual results of children with ectopia lentis after lensectomy. METHODS: Enrolled in this study were 79 eyes of 43 patients who were operated on and followed up for at least 3 years. We performed a retrospective analysis of the patient records. RESULTS: The mean age at diagnosis was 4.6 years, mean age at surgery was 5.7 years and average follow-up was 7.1 years. Of the 43 patients with bilateral ectopia lentis, 7 underwent monocular surgery. The mean age at diagnosis was higher and mean postoperative BCVA was significantly lower in the monocular surgery group than in the binocular surgery group. All eyes showed reduced hyperopia for 5 years postoperatively, but the reduction rate of the monocular operated eyes was significantly lower than that of the binocular operated eyes (P<0.05). No complication occurred during surgery and 1 eye (1.3%) with Marfan syndrome showed retinal detachment 9 years after surgery. CONCLUSIONS: Surgical treatment of ectopia lentis was safe and showed good visual outcomes after 7.1 years of follow-up. Nevertheless, consideration must be given to the possibility of amblyopia due to the difference of the degree of dislocation between the two eyes.

Comparison of Anterior Capsule-Sparing Lensectomy and Phacoemulsification in Combined Pars Plana Vitrectomy

PURPOSE: We compared anterior capsule-sparing lensectomy and phacoemulsification performed during vitrectomy. METHODS: We reviewed the data of 103 eyes with combined surgery of the lens and vitreous: lensectomy had been performed in 61 eyes, and phacoemulsification in 42. RESULTS: Proliferative diabetic retinopathy was the most common indication of operation in both groups. Miosis occurred during operation in 1 eye (1.6%) of the lensectomy patients, and in 5 eyes (11.9%) of the phacoemulsification patients; the difference was statistically significant (p<0.05). Postoperative visual acuity improved in 68.9% and 64.3% of the patients in the lensectomy and phacoemulsification groups, respectively. No difference was found between the groups in the rate of other complications including capsular opacity, neovascular glaucoma, etc. CONCLUSIONS: There was no difference in the surgical outcomes between the two groups except for the higher rate of miosis during operation in the phacoemulsification group. Anterior capsule sparing lensectomy could be an alternative method in the selected patients.

Reservation of Anterior Lens Capsule in Intraocular Lens Implantation after Lensectomy

As combined procedure with pars plana vitrectomy, pars plana lensectomy lowers the incidences of corneal edema and constriction of pupil, and elimi-nates the risk of corneal incision leakage.When intraocular lens is inserted, conventional procedure requires large anterior capsulectomy to prevent after-cataract.To maintain barrier between anterior and posterior seg-ments, anterior capsule was preserved and lens epithelial and cortical cells were polished off thoroughly with enhancement of visualization by intraocu-lar illuminator.Intraocular lenses were inserted into ciliary sulcus after vitrectomy.After a minimum of 1 year, postoperative vision was better in 17 of the 24 eyes (71%).the same in six eyes (25%)and worse in one eye (4%). Postoperative complications included after-cataract in 4 eyes (17%), decen-tration of intraocular lens in 2 eyes (8%), retinal detachment in 1 eye (4%) and neovascular glaucoma in 1 eye.Only two eyes required Nd:YAG laser capsulotomies. If intraocular illumination is utilized properly, lens epithelial and cortical cells can be removed thoroughly after pars plana lensectomy combined with vitrectomy and anterior capsule can be maintained without significant increase of after-cataract.

After-Cataract Following Pars Plana Lensectomy and PCL Implantation

We evaluated after-cataract, capsular opacification, following combined lens removal with phacoemulsification or pars plana lensectomy, pars plana vitrectomy and primary or secondary IOL implantation on 34 eyes followed up more than 3 years.For the lens removal 23 eyes had pars plana lensectomy ad 11 eyes phacoemulsification. Nd-YAG capsulotomy is needed on 8/34 eyes(25.5%). Nd-YAG capsulotomy was performed on 3/23 eyes(13%) of pars plana lensectomy and on 5/11 eyes(45.5%) of phacoemulsification. Nd-YAG capsulotomy was performed to 7/22 eyes(31.8%) of primary IOL implantation and 1/12 eyes(8.3%) of secondary IOL implantation. Most patients had systemic vascular disease such as diabetes or hypertension.In conclusion, combined pars plana lensectomy, pars plana vitrectomy and secondary IOL implantation was the least incidence of after-cataract and side effects, so this procedure was thought to be recommended for vitreoretinal surgery.

Corneal Endothelial change following Par Plana Vitrectomy with Expanding Gas

We performed prospective study of corneal endothelial damage associated with expanding gas during pars plana vitrectomy in 33 patients. A total of 16 eyes were performed vitrectomy with lens removal(intact anterior capsule), only 6 eyes in the gas treated group and 10 eyes in the control group. Among 19 eyes underwent vitrectomy without lens removal, 10 eyes treated with the expanding gas, which was not performed in the other 9 patients. The corneal endothelium was examined with a noncontact specular microscopy preoperatively and 3 months postoperatively. Endothelial changes were analyzed by comuterized morphometric data of individual cells and represented cell density, coefficient of variation, and hexaponality. The mean endothelial cell loss was 2.73% in 9 phakic eyes which underwent vitrectomy without expanding gas and 5.99% in 10 phakic eyes which underwent vitrectomy with expanding gas. In aphakic eyes, vitrectomy was comvined with lensectomy and expanding gas, the mean endothelial cell loss was 6.81%. The changes of endothelial cell density and hexagonality were not statistically significant. But coefficient of variation in aphakic eyes with vitrectomy using expanding gas was higher compared with other groups. As our results, although the difference of coefficient of expanding gas during vitrectomy in aphakic eyes seems to be safe. Because during vitrectomy with expanding gas in aphakic eyes.

Surgical Results of the Uncomplicated Giant Retinal Breaks

The surgical success rate for retinal detachment caused by giant retinal breaks was very low in the past because of its frequent association with proliferative vitreoretinopathy and inverted retina I flap. Recently advances in vitreoretinal surgical techniques as well as introduction of perfluorocarbon liquid result in good surgical results. Eleven eyes with uncomplicated retinal detachment from giant retinal breaks underwent vitrectorny. A special effort was made to remove as much vitreous gel of the vitreous base as possible. Lensectomy or encircling was performed, when needed. Inverted retinal flap was unfolded using perfluorocarbon liquid. After laser ph/otocoagulation, internal tamponade was performed with C3 F8 gas or silicone oil. Postoperatively, we achieved anatomical success in all eleven eyes and favorable visual acuity of better than 0.4 in nine eyes(81.8%). We obtained good surgical results for uncomplicated giant retinal breaks using meticulous vitreous base dissection and perfluorocarbon liquid. Removal of crystalline lens or scleral buckling is not always needed in this complex retinal detachment surgery.

Comparison of the Clinical Results of Lensectomy and LASIK for High Myopia

We retrospectively evaluated clinial results of 13 eyes of 8 patients who underwent lensectomy and 11 eyes of 7 patients who underwent LASIK(laser assisted in sity keratomileusis) for correction of high myopia. Clinical outcomes of uncorrected and corrected visual acuity, postoperative refraction, and contrast sensitivity were evaluated. Subjective tests concerning glare, night halos, or decrement of night vision were also performed in each group. Postoperative uncorrected and corrected visual acuities were not significantly different between two groups. Predicatability was significantly higher in lensectomy group than that of LASIK group. Mean contrast sensitivity value of highest frequency(20 cpd) in LASIK group was significantly lower than that in lensectomy group. Subjective glare or night hlaos occurred more in LASIK group. During follow-up, visual loss with 2 lines or more was noted in 2 eyes due to postoperative complications in lensectomy group. No complication occurred in LASIK group. LASIK has been considered reasonably predictable and safe method for correction of high myopia. But our data suggest that lensectomy may give better quality of vision postoperatively compared to LASIK for high myopia. If prophylactic treatments which are aimed to prevention of postoperative complications are carried out prior to lensectomy, lensectomy is a reasonable refractive surgical potion especially for middle-aged patients with high myopia.

Pars Plana Vitrectomy Combined with Anterior Capsule-Sparing Lensectomy Clinical Report of 43 Cases

We performed pars plana vitrectomy combined with anterior capsule-sparing lensectomy on forty three eyes WJth coexisting cataract and vitreoretinal disease and followed up more than 6 months. Preoperative vitreoretinal diseases consisted of nondiabetic vitreous hemorrhage (thirteen eyes), retained metallic intraocular foreign bodies (nine eyes), posterior uveitis (nine eyes), proliferative diabetic retinopathy (seven eyes) and rhegmatogenous retinal detachment (five eyes) . Thirty six eyes (84%) revealed the visual acuity of 0.1 or less before operation. Thirty eight eyes (88%) could get a better visual acuity after operation than before operation. Posterior chamber intraocular lenses were implanted to thirty eight eyes. The severity of anterior capsular opacity showed a statistically significant difference between the eyes with injection of intraocular gas or silicone oil and them without injection of that (p=0.004). In this study, we can find that the technique of pars plana vitrectomy combined with anterior capsule-sparing lensectomy would be recommendable and the anterior capsular opacity may have relation with intraocular gas or silicone oil.

Posterior Chamber Intraocular Lens Implantation Combined with Pars Plana Lensectomy and Intraocular Foreign Body Removal

Four patients with intraocular foreign bodies and traumatic cataracts underwent combined pars plana lensectomy, vitrectomy, and intraocular foreign body removal. During pars plana lensectomy, anterior lens capsule and zonules were left intact. At the end of surgery, a posterior chamber intraocular lens was placed in the sulcus in front of the anterior capsule through a 7-mm limbal incision. This procedure was performed in selected cases of combined anterior and posterior segment trauma. Combining pars plana lensectomy and posterior chamber intraocular lens implantation with posteior segment procedures allows rapid visual rehabilitation and functional unaided vision. We therefore suggest that this technique is effective in treating selected patients with both cataract and vitreoretinal diseases.