Hybrid 20/23-Gauge Pars Plana Vitrectomy for Retained Lens Fragments After Cataract Surgery

Barthelmes, Daniel; Alexander, Sheena Mary; Mitchell, Paul; Chandra, Jay

doi:10.1097/iae.0b013e3182453309

Cited by 21 publications

(21 citation statements)

References 28 publications

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“…Other techniques have been proposed to try to minimize the use of 20‐gauge frag and reduce the intra‐ and postoperative complication rate (Röver ; Barthelmes et al. ; Erakun et al. ; Shapiro et al.…”

Section: Discussionmentioning

confidence: 99%

Nitinol basket‐assisted pars plana vitrectomy for retained lens material removal

Iannetta

Engelbrecht

Mura

2018

Acta Ophthalmologica

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Section: Discussionmentioning

confidence: 99%

Nitinol basket‐assisted pars plana vitrectomy for retained lens material removal

Iannetta

Engelbrecht

Mura

2018

Acta Ophthalmologica

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“…Recently, small-gauge transconjunctival sutureless PPV have been reported for the removal of retained lens fragments. [14][15][16][17] The small-gauge vitrectomy permits the use of smaller self-sealing wounds that may allow patients to recover quicker. However, complications, including wound leakage, hypotony, vitreous incarceration, choroidal detachment, and endophthalmitis, have been associated with the small, sutureless self-sealing wounds.…”

Section: Discussionmentioning

confidence: 99%

“…A suture was used to close the expanded sclerotomy site and reapproximate the conjunctiva after lens fragment removal. [14][15][16][17] Horiguchi et al 10 described a technique for removing lens fragments dropped into the vitreous cavity during cataract surgery using an optical fiber-free intravitreal surgery system that was developed for bimanual vitrectomy. The advantages of optical fiber-free intravitreal surgery system surgery are a wider field-of-view (40 · 40°) and bimanual technique.…”

Section: Discussionmentioning

confidence: 99%

Immediate Corneal Vitrectomy for Posteriorly Dislocated Lens Fragments During Cataract Surgery

Wang

Zhao

et al. 2013

Retina

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D espite continuing improvements in machines and surgical techniques for phacoemulsification, dislocation of crystalline lens fragments into the vitreous cavity is an uncommon but has potentially serious complications. The rate of retained lens fragments during phacoemulsification is estimated to be 0.3% to 1.1%. 1,2 Retained lens fragments can lead to intraocular inflammation, cystoid macular edema, epiretinal membrane formation, phacoanaphylaxis, increased intraocular pressure (IOP), and corneal edema and may be associated with retinal detachment. 3 Pars plana vitrectomy (PPV) for posteriorly dislocated lens fragments has been reported to be associated with visual acuity improvement and control of inflammation and IOP in most patients. Although the best time at which vitrectomy should be performed after cataract surgery is under debate, immediate or early vitrectomy theoretically should reduce the severity of uveitis, the incidence of cystoid macular edema, and glaucoma, 4,5 and these findings have been reported in some series. 6-9 However, immediate PPV can be difficult for cataract surgeons who have not been trained in the technique. 10 As a general rule, cataract surgeons who have experience with retinal surgery can remove dislocated nuclear fragments during cataract surgery if the appropriate basal vitreal instruments are available.More recently, Nakasato et al 11 reported a new surgical technique of removing dislocated nuclear fragments with fragmatome with 27-gauge chandelier endoilluminator fiber through the sclerocorneal incision made for cataract surgery. The limitations of this method were a relatively large sclerocorneal incision and been used in the dislocated nuclear fragments smaller than one fourth of the size of the lens nucleus. Furthermore, some additional kinds of equipment or instruments are needed. 12 In this study, we report our experience in immediately removing dropped lens fragments that are smaller than one half of the size of the lens nucleus during complicated cataract surgery. The technique is simple and useful because posterior core vitrectomy and lens removal can be performed through three corneal ports without additional equipment and instruments. Patients and MethodsThe medical records of all consecutive patients were identified by searching the Department of Ophthalmology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, from April 2007 through December 2011. All surgeries were performed by the same experienced surgeon (P.-Q.Z.) using the Accurus 800 CS Phaco-Vitrectomy System (Alcon Laboratories, Fort Worth, TX). Pre-, intra-, and postoperative medical record data were retrospectively collected. Demographic information, preexisting eye diseases, previous eye surgical procedures, pre-and postoperative ocular medications, and details of the initial and final examinations including best-corrected visual acuity, IOP, PPV surgery details, and postoperative complications were noted. All patients were examined for posterior vitreous detachment by B-scan ultrasonograp...

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“…Since studies by Kiss and Vavvas in 2008 [58] and Ho et al in 2010 [59] describing use of 25G instrumentation for lens fragment removal, many studies have evaluated the use of smaller gauge sutureless techniques [60][61][62][63][64]. Since studies by Kiss and Vavvas in 2008 [58] and Ho et al in 2010 [59] describing use of 25G instrumentation for lens fragment removal, many studies have evaluated the use of smaller gauge sutureless techniques [60][61][62][63][64].…”

Section: New Developmentsmentioning

confidence: 99%

2013 update on the management of posterior capsular rupture during cataract surgery

Chiu

2014

Current Opinion in Ophthalmology

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Hybrid 20/23-Gauge Pars Plana Vitrectomy for Retained Lens Fragments After Cataract Surgery

Abstract: Dropped lens fragments because of complicated cataract surgery can be managed well with 23-gauge pars plana vitrectomy: The majority of patients achieve a good visual acuity despite 2 surgeries at a rather low rate of retinal complications.

Cited by 21 publications

References 28 publications

Nitinol basket‐assisted pars plana vitrectomy for retained lens material removal

Nitinol basket‐assisted pars plana vitrectomy for retained lens material removal

Immediate Corneal Vitrectomy for Posteriorly Dislocated Lens Fragments During Cataract Surgery

2013 update on the management of posterior capsular rupture during cataract surgery

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