Intravitreal Phacoemulsification with Pars Plana Vitrectomy for Management of Posteriorly Dislocated Nucleus or Lens Fragments

Mahdy, Mahmoud A.; Eid, Mohamed Zakaria; Shalaby, Khalid Abdel-Gelil; Hegazy, Hasan Mohamed

doi:10.1177/112067211002000115

Cited by 21 publications

(9 citation statements)

References 18 publications

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“…In vitro study showed that PFCL is directly toxic to human retinal pigment epithelial cells when exposed to the cells for 7 days 21. Ruiz–Moreno et al 22 and Soliman Mahdy et al 23 have performed intravitreal phacoemulsification with a conventional probe devoid of its silicone sleeve for removal of dislocated nucleus/lens fragments. Complications reported in their series were retinal tears at the time of surgery and retinal detachment postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

Agarwal

Narang²,

Kumar

et al. 2014

Br J Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

Agarwal

Narang²,

Kumar

et al. 2014

Br J Ophthalmol

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“…Although our PPV with the phacoemulsification method in the vitreous cavity17,18 does not require any enlargement of the scleral limbal wound, it is possible that a retinal tear or vitreous hemorrhage could occur due to the ultrasound energy present 19. Other reported methods that can be used in such cases involve lifting the lens into the anterior chamber, with removal then performed via a scleral limbal wound 5,10.…”

Section: Discussionmentioning

confidence: 99%

Use of pars plana vitrectomy with phacoemulsification in vitreous cavity to treat complete posterior dislocation of lens

Mutoh¹,

Matsumoto²,

Chikuda³

2011

OPTH

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BackgroundThe purpose of this study was to evaluate pars plana vitrectomy (PPV) with phacoemulsification in the vitreous cavity for treatment of complete posterior dislocation of the lens without any damage to the lens capsule.MethodsWe evaluated factors such as cause of dislocation, scleral fixation of an intraocular lens (IOL), preoperative and postoperative visual acuity, corneal endothelial cell density, and intraoperative and postoperative complications.ResultsDisplacement in the eleven eyes studied was mostly caused by ocular trauma and was idiopathic (four eyes each). Scleral fixation of the IOL was performed in seven of the eyes during first-time PPV. Visual acuity was improved in two eyes, unchanged in eight eyes, and worse in one eye. Mean corneal endothelial cell density was 2485 cells/mm2 preoperatively and 2301 cells/mm2 postoperatively. No significant differences were seen before and after the surgeries (P = 0.15, paired t-test). Intraoperative complications included retinal detachment and suprachoroidal hemorrhage in one eye each. The most common postoperative complication was transient ocular hypertension, which occurred in three eyes. IOL dislocation and vitreous incarceration of the anterior chamber in one eye required a second operation, while retinal detachment in one eye required a third operation.ConclusionWhen treating a completely dislocated lens, prevention of retinal detachment which subsequently can affect the visual prognosis is the most important factor to be addressed after PPV with intravitreal phacoemulsification.

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“…30,31,36,[47][48][49][50][51] However, some studies suggest that vitrectomy undertaken at the time of cataract surgery (if a vitreoretinal surgeon is available) or within 3 weeks, may improve overall visual outcome and reduce the risk for chronic elevation of intraocular pressure. [52][53][54] One systematic review and meta-analysis of retrospective interventional case series found optimal timing for vitrectomy in cases not requiring early PPV (i.e., in cases involving retinal detachment or endophthalmitis) to be between days 3 to 7 following cataract surgery. 55 A significant association between retinal detachment and PPV performed more than 30 days after cataract surgery has also been shown.…”

Section: Timing Of Pars Plana Vitrectomymentioning

confidence: 99%

Current Medical and Surgical Management of Retained Lens Fragments After Cataract Extraction

Schaal¹,

Nesmith²,

Ihnen³

et al. 2014

US Ophthalmic Review

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Purpose:To review current literature understanding and modern clinical guidelines, and to provide contemporary management recommendations regarding the medical and surgical management of retained lens fragments (RLF) after cataract surgery.Methods:Literature review for articles published in the PubMed database between 1948 and 2014 with the following keywords: retained lens fragments, retained lens material, dropped nuclear fragments, dislocated lens.Results:RLF is a complication of cataract surgery, with incidence reported between 0.18 % and 1.1 %, which can result in severe inflammatory reaction, leading to significant vision-threatening complications, including cystoid macular edema, glaucoma, uveitis, and corneal edema. Management of RLF can be either medical or surgical, depending upon the severity of inflammation and symptoms. Proper timing of either medical or surgical management is crucial in preventing visual loss.Conclusion:RLF is a well-known complication of modern cataract surgery that should be managed promptly medically or surgically. Close cooperation between the anterior segment and posterior segment surgeon is crucial for optimal results.

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Intravitreal Phacoemulsification with Pars Plana Vitrectomy for Management of Posteriorly Dislocated Nucleus or Lens Fragments

Cited by 21 publications

References 18 publications

Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

Use of pars plana vitrectomy with phacoemulsification in vitreous cavity to treat complete posterior dislocation of lens

Current Medical and Surgical Management of Retained Lens Fragments After Cataract Extraction

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