Managing Challenges of Phacoemulsification in Vitrectomized Eyes: A New Technique

Middle East Afr J Ophthalmol. 2020 Apr 29;27(1):53-55. doi: 10.4103/meajo.MEAJO_257_19. eCollection 2020 Jan-Mar.

Abstract

Aim: This study aimed to describe a novel approach to manage the challenges of phacoemulsification in vitrectomized eyes.

Methods: Intraoperative titrated intravitreal injection of balanced salt solution (BSS) through pars plana was done using a 30G needle hooked to a 1 cc syringe to build up the vitreous pressure.

Results: Five eyes of five patients who had previous vitrectomy were given intraoperative injection. This led to the prevention of lens-iris diaphragm retropulsion and routine completion of phacoemulsification. The preoperative visual acuity was < 6/60 in all patients. The postoperative visual acuity was 6/9 or better in all patients, except in one patient which was 6/60, which is explained by diabetic ischemic maculopathy. Neither injection-related intraoperative nor postoperative complications were noted.

Conclusion: Challenges of phacoemulsification in vitrectomized eyes can be prevented by a simple titrated intraoperative injection of BSS intravitreally through pars plana.

Keywords: Lens–iris diaphragm retropulsion syndrome; phacoemulsification; vitrectomized eyes.

MeSH terms

  • Acetates / administration & dosage*
  • Aged
  • Drug Combinations
  • Female
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications / prevention & control*
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Minerals / administration & dosage*
  • Phacoemulsification / methods*
  • Sodium Chloride / administration & dosage*
  • Visual Acuity / physiology
  • Vitrectomy*
  • Vitreous Body / surgery*

Substances

  • Acetates
  • BSS solution
  • Drug Combinations
  • Minerals
  • Sodium Chloride