Peripheral retinal examination in pseudophakia

ABSTRACT

Peripheral retinal examination in pseudophakia is a challenge for the posterior segment surgeon. We have studied 62 cases of planned extracapsular cataract extraction [ECCE] and intraocular lens implantation [IOL] regarding three factors the type of anterior caps-ulotomy, the size of optic of the implant and the method of examination. We compared three methods of examination the Goldmann three mirror lens, the Volk quadraspheric lens and the indirect opthalmoscopy. We found that in cases implanted with 5.5 mm optic IOL the equator was the most difficult area to examine with the Goldmann lens. Only in 26.6% of our cases the equator was visible with this method. The Volk quadraspheric lens can cover this area. With the 7 mm optic IOL the problem was in visualizing the periphery of the retina. This was seen in 68% by using the three mirrors lens and in none by using the Volk lens. The best method for examining the retinal periphery in both sizes of optic was the indirect opthalmoscopy. The anterior capsule did-not impose any difficulty in fundus examination in our cases. We recommend, in case of potential retinal pathology, to implant a wide optic lens at least 7 mm and to perform a large capsulorhexis opening of the same size of the implant in order to give the best chances of peripheral retinal visualization for the posterior segment surgeon