Purpose To evaluate the technique of vitreous tap using needle aspiration for management of anterior chamber shallowness during phacoemulsification. Methods A retrospective study included 26 eyes of 17 patients who underwent phacoemulsification in which vitreous tap was performed using a 27-gauge needle attached to a 5 ml syringe, inserted 3.5 mm from the limbus to aspirate 0.2 ml of liquefied vitreous if a cohesive (OVD) failed to sufficiently deepen the anterior chamber. Results Preoperative anterior chamber depth was 2.31 ± 0.26 mm, axial length was 21.7 ± 0.67 mm, lens thickness was 4.5 ± .19 mm, and cataract grade was 3.77 ± 1.4. Preoperative CDVA in LogMAR units was 0.98 ± 0.75. Coexisting angle closure glaucoma was present in 7 patients (26.92%) preoperatively. Vitreous needle tap was successful in vitreous removal on the first attempt in 26 eyes (100%). Postoperative follow-up period was 22.88 ± 10.24 (4–39) months. The final postoperative CDVA in LogMAR units was 0.07 ± 0.1, while the final postoperative IOP was 16.54 ± 1.45 mmHg. No complications related to vitreous tap were noted. Conclusion Vitreous needle tap is a simple, cost-effective, and safe technique for management of shallow anterior chamber in phacoemulsification.

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Purpose To evaluate corneal transparency following accelerated collagen cross-linking (ACXL) in pediatric keratoconus. Design A prospective interventional case series. Methods This study included 47 eyes (25 patients), aged 9–14 years, with documented progressive keratoconus. After applying 0.1% riboflavin drops, ACXL was performed. Assessment included corrected distance visual acuity (CDVA), uncorrected visual acuity (UCVA), corneal haze, and corneal densitometry in grayscale units (GSU). Result The mean baseline and corneal densitometry peaked at 3 months post-ACXL while central and posterior densitometry showed a statistically significant increase (P < 0.05) and peaked at 8 months postoperatively. By 12 months, densitometry in all corneal layers (P ≥ 0.99) and concentric zones (P ≥ 0.97) reached near baseline values. Slit-lamp graded haze peaked at 1 month to 1.82 ± 0.65 (P < 0.05) and declined to near baseline at 12 months (0.39 ± 0.58). There was a statistically significant increase in the mean UCVA and CDVA at 12 months. Conclusion Total and anterior corneal densitometry peaked after 3 months, while central and posterior densitometry peaked after 8 months. Maximum haze was at 1 month post-ACXL. All corneal layers, concentric zone densitometry and haze reached near baseline values after 1 year. Scheimpflug densitometry showed weak correlation with CDVA over the 12-month follow-up period (r = −0.193).

PurposeTo evaluate the safety and efficacy of surgeon’s superior sitting position during temporal clear corneal incision (TCCI) phacoemulsification, with a 90° working angle, during combined phacovitrectomy.MethodsProspective interventional case series were performed on 65 eyes of 63 patients. TCCI phacoemulsification was done in all cases (whether right or left eyes), while the surgeon was sitting superiorly to the operating table.Outcome measures includedShift in sitting position, keratometric astigmatism, surgically induced astigmatism, posterior capsule integrity, and intraocular lens centration.ResultsPhacoemulsification was performed completely in all cases (100%). Shift in position to temporal sitting position happened in two cases (3%). The keratometric astigmatism showed mean changes of 1.09 D (0.25–3.75 D) to 0.84 D (0.00–3.25 D) at 1 month, which remained stable at 6 months; 0.84 D (0.16–3.21 D). The surgically induced astigmatism was 0.25 DC (−0.50 to 1.0 DC) at 1 month, which stayed stable at 6 months; 0.25 D (−0.63 D to 0.98 D). Posterior capsular rupture occurred in one case (the second case) (1.5%). The intraocular lens was centered in all cases (100%).ConclusionSuperior sitting TCCI phacoemulsification, with a wide working angle, during combined phacovitrectomy proved safe and easy, without the burden of changing and disrupting the operative setting. The anatomical and optical outcomes were acceptable.

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