Intraocular Surgery in Kyphosis: An Easier Approach

Abstract

We describe a 49-year-old man with advanced kyphosis and dense cataract, who could only recline to about 40° from the vertical axis despite a maximal reverse Trendelenburg position and pillows under the head, neck, shoulders and knees. With a single corneal retraction suture at 6 o'clock, the eye could be rotated horizontally, which enabled the surgeon to perform a complex cataract surgery despite prior glaucoma shunt, posterior synechiae, a small pupil and the need to stain the capsule. As the eye can be brought into any desired position with a retraction suture, patients with kyphosis or other conditions that prevent them from assuming a supine position can still have safe intraocular procedures. This maneuver reduces the need to tilt patients to an uncomfortable position that may cause pain, increased breathing difficulty and elevated posterior vitreous pressure.

Implication of Corneal Refractive Surgery in Duchenne Muscular Dystrophy

“…Depending on the degree of scoliosis or kyphoscoliosis, various interventions have been utilized in unaffected individuals in cataract surgery. One approach for a patient who could only recline to 40° from the vertical axis utilized a 6 o’clock suture to adjust the eye as needed [ 30 ]. However, this technique might lead to undesirable outcomes in corrective vision procedures.…”

“…Depending on the degree of scoliosis or kyphoscoliosis, various interventions have been utilized in unaffected individuals in cataract surgery. One approach for a patient who could only recline to 40°from the vertical axis utilized a 6 o'clock suture to adjust the eye as needed [30]. However, this technique might lead to undesirable Vasculitis [23] Neovascularization [23] Retinal testing Electroretinography Significant amplitude response decrease [27] Color and contrast sensitivity Decreased red-green color sensitivity [19] Decreased contrast sensitivity [22] Case Reports in Ophthalmology outcomes in corrective vision procedures.…”