Chandelier-assisted retroillumination for phacoemulsification in phacovitrectomy

Nagpal, Manish; Mahuvakar, Sheetal; Chaudhary, Pranita; Mehrotra, Navneet; Jain, Ashish

doi:10.4103/ijo.ijo_85_18

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…10 The absence of an adequate red reflex due to vitreoretinal pathology is associated with a higher incidence of complications during phacoemulsification. 11,12 In our study, a direct cause could not be extrapolated to explain complications during phacoemulsification as only one patient who had an extended capsulorhexis had a total RD with a less than adequate red reflex.…”

Section: Discussionmentioning

confidence: 74%

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Helmy

Dahab

Abdelhakim

et al. 2020

African Vision and Eye Health

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Performing a staged procedure is advocated to overcome some of the intraoperative difficulties and postoperative complications that may occur with a combined procedure. These complications would not normally occur with vitrectomy alone, including corneal oedema, narrow pupil intraoperatively, and anterior chamber reaction with fibrinous exudate formation and posterior capsular opacification postoperatively. 5Background: A cataract inevitably develops after pars plana vitrectomy (PPV) with silicone tamponade. In patients with rhegmatogenous retinal detachment (RRD) of presbyopic age and without significant cataracts, phacoemulsification can be deferred to the time of silicone removal. Alternatively, it can be performed with PPV. Sparse evidence exists to choose one option over the other; this is usually left to the surgeon's preference.Aim: To compare PPV with silicone tamponade alone, or combined with phacoemulsification for primary RRD, in patients without significant cataracts.Setting: This is a comparative prospective randomised interventional study that was conducted in Cairo University hospitals. Methods:The patients were randomised to two groups, each with 20 phakic patients presenting with RRD. Patients in Group A were randomised to PPV, followed by the phacosilicone removal. Patients in Group B were randomised to phaco-vitrectomy, followed by silicone removal. Results:No statistically significant difference existed between the groups regarding the rate of intraoperative complications. Group B patients had a higher rate of early postoperative complications (intraocular pressure [IOP], corneal oedema and anterior chamber reaction). At final follow-up there was no statistically significant difference between the groups regarding the rate of retinal attachment or the best corrected visual acuity. Calculation of lens power was significantly more accurate in Group A, as evidenced by the difference in the mean spherical equivalent (Group A: -0.75 dioptre [D] vs Group B: -2.5 D, p = 0.031). Conclusion:This study suggests that no difference exists between the surgical options regarding anatomical success and intraoperative complications. Deferring phacoemulsification until the time of silicone oil removal offers an option with fewer early postoperative complications and more accurate lens power calculation.

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Section: Discussionmentioning

confidence: 74%

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Helmy

Dahab

Abdelhakim

et al. 2020

African Vision and Eye Health

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Evaluation of the safety of anterior capsule staining with trypan blue under air: a retrospective analysis

Park¹,

Lee²,

Jo³

et al. 2022

Int J Ophthalmol

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AIM: To evaluate the safety of using 0.03% trypan blue under air for anterior capsule staining in cataract surgery. METHODS: The current study involved a retrospective analysis of the medical records of 86 patients with vitreous hemorrhage, who underwent pars plana vitrectomy and cataract surgery. The patients were classified into two groups. The trypan blue group (n=45) comprised patients who underwent anterior capsule staining with 0.03% trypan blue under an air bubble. The control group (n=41) comprised of patients who underwent intracameral illuminator-assisted capsulorhexis. The status of endothelial cell density (ECD) in both the groups was analyzed. RESULTS: The trypan blue group displayed significant decline in ECD at 1mo (7.91% loss, P<0.001) and 3mo (9.65% loss, P<0.001) after the surgery, whereas no significant changes were observed in the control group. Moreover, the number of patients who did not display a postoperative decline in ECD was significantly higher in the control group (43.9%; 18 patients) than in the trypan blue group (17.1%; 7 patients, P=0.004). CONCLUSION: Anterior capsule staining with trypan blue under the air bubble would not be as safe as the intracameral illuminator. The ECD loss might be attributed to the air bubble rather than to the deleterious effects of 0.03% trypan blue. Further studies are required to clarify this.

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Evaluation of endolight-assisted phacoemulsification in cataract with absent red reflex

Elkhawaga,

Elbaha

2023

Delta Journal of Ophthalmology

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Purpose The aim of this study was to evaluate the outcome of cataract extraction in eyes with absent red reflex using anterior chamber endolight. Patients and methods This is a prospective interventional case series study that was performed on 32 eyes of 32 patients with cataract associated with absent red reflex. Phacovitrectomy was performed in all patients. An anterior chamber endolight, introduced through a paracentesis, was used to enhance the phacoemulsification technique. The effectiveness of the technique in facilitating the visualization of the lens structures during the procedure and in enhancing the easiness of the operation as well as the complications related to this technique were evaluated. In addition, the improvement in visual acuity in these patients after surgery was evaluated. Results No complications were reported during any of the operations. The endolight promptly enhanced the visualization of the lens structures especially the posterior capsule. The mean best corrected visual acuity significantly improved from 2±0.31 LogMAR preoperatively to 0.38±0.17 postoperatively after combined phacovitrectomy (P<0.001). Conclusion The endolight aided in improving the safety profile of phacoemulsification in cataract with absent red reflex by increasing the visibility of anterior chamber structures during the procedure.

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Chandelier-assisted retroillumination for phacoemulsification in phacovitrectomy

Cited by 3 publications

References 20 publications

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Vitrectomy and silicone oil tamponade with and without phacoemulsification in the management of rhegmatogenous retinal detachment: A comparative study

Evaluation of the safety of anterior capsule staining with trypan blue under air: a retrospective analysis

Evaluation of endolight-assisted phacoemulsification in cataract with absent red reflex

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