Phacoemulsification in a vitrectomized eye is associated with a higher rate of posterior capsule rupture than the one in combined vitrectomy. These results may have been caused by hard nucleus cataract in a vitrectomized eye.

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We describe a surgeon-controlled-endoillumination-guided irrigation and aspiration (I/A) technique that can be used to polish the posterior capsule during combined 23-gauge sutureless vitrectomy and cataract surgery in eyes with a poor red fundus reflex. In a dark room with the microscope light turned off, the surgeon holds and controls a 23-gauge endoilluminator with the left hand to achieve better retroillumination during I/A. Using surgeon-controlled endoillumination, it is possible to follow and guide the posterior capsule area undergoing I/A. The excellent visibility of the posterior capsule facilitates posterior capsule polishing with no intraoperative complications.

Aims:To compare the corneal refractive changes induced after 3.0 mm temporal and nasal corneal incisions in bilateral cataract surgery.Materials and Methods:This prospective study comprised a consecutive case series of 60 eyes from 30 patients with bilateral phacoemulsification that were implanted with a 6.0 mm foldable intraocular lens through a 3.0 mm horizontal clear corneal incision (temporal in the right eyes, nasal in the left eyes). The outcome measures were surgically induced astigmatism (SIA) and uncorrected visual acuity (UCVA) 1 and 3 months, post-operatively.Results:At 1 month, the mean SIA was 0.81 diopter (D) for the temporal incisions and 0.92 D for nasal incisions (P = 0.139). At 3 months, the mean SIA were 0.53 D for temporal incisions and 0.62 D for nasal incisions (P = 0.309). The UCVA was similar in the 2 incision groups before surgery, and at 1 and 3 months post-operatively.Conclusion:After bilateral cataract surgery using 3.0 mm temporal and nasal horizontal corneal incisions, the induced corneal astigmatic change was similar in both incision groups. Especially in Asian eyes, both temporal and nasal incisions (3.0 mm or less) would be favorable for astigmatism-neutral cataract surgery.

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