Phacoemulsification in the anterior chamber: An alternative surgical technique in post-vitrectomy cataract

Abstract

Objective:To evaluate the characteristics, safety and effectiveness of a modified technique of phacoemulsification in post-vitrectomy cataracts.Methods:This retrospective clinical trial comprised 31 patients (31 eyes) with post-vitrectomy cataract, who had undergone phacoemulsification combined with intraocular lens implantation. An alternative surgical technique known as phacoemulsification in the anterior chamber was used for nucleus management in those cases. The following parameters were evaluated: best corrected visual acuity (BCVA), ocular inflammation, intraocular pressure, endothelial cell count and surgical complications.Results:Three months after surgery, the BCVA improved significantly compared with that before surgery (Z=-10.547; p<0.05). There were no significant differences in IOP before and after surgery (Z=-0.474; p>0.05). There was a statistically significant postoperative decrease in endothelial cell densities (Z=-3.916; p<0.05). The mean endothelial cell loss was -8.71%. A little inflammatory response in the anterior chamber in 11 eyes and mild corneal edema in 8 eyes were observed on the first day after surgery, which subsided after a week. The posterior capsular opacification were observed in three eyes, two of which were denser, and the YAG laser was performed for posterior capsular incision. No obvious surgical complications occurred.Conclusion:The modified technique of phacoemulsification, with phacoemulsification in the anterior chamber, is safe and effective to deal with post-vitrectomy cataracts.

Application of Prechop Technique in Phacoemulsification for Cataract Patients with Highly Liquefied Vitreous: A Retrospective Study

“…A similar technique was reported by Yu et al, who recommended phacoemulsi cation in the anterior chamber for post-vitrectomy cataract. 10 In conclusion, the results of our study are encouraging that the prechop technique was found to have less intraoperative complications, reduced phaco time and CDE compared to standardized phaco-chop during cataract phacoemulsi cation surgery. It might be a good alternative for cataract surgery for patients with highly lique ed vitreous, such as in high myopia-related and post-vitrectomy cataract, especially those with hard nucleus.…”

“…Cataract surgery in patients with highly lique ed or vitrectomized vitreous is challenging due to its unique anatomical structures. To solve this problem, previous researchers, such as Li et al 5 and Yu et al 10 has reported modi ed methods which had certain effectiveness in improving the safety of surgery and reducing complications, but there are still some limitation for their methods. In the current study, we reported with encouraging results that prechop technique had an advantage in treating patients with highly lique ed vitreous compared to conventional phaco chop during cataract surgery.…”

“…Consequently, in order to achieve a stable balanced pressure, multiple injections of water are needed, which increase the times of surgical instruments moving in and out and cause a discontinuous procedure. Yu et al 10 reported a modi ed technique, with phacoemulsi cation in the anterior chamber, to deal with post-vitrectomy cataracts. Nevertheless, this procedure requires a relatively big capsulorrhexis margin which may affect the stability of intraocular lens (IOL) in the capsular bag.…”

Phacoemulsification in vitrectomized eyes: Maintaining the stability of the anterior chamber via a new technique

“…However, if the height of irrigating fluid is kept excessively low, the Phaco cannot proceed efficiently. Yu et al 9 have tried rotating the nucleus from the capsular bag to the anterior chamber for Phaco to reduce the pressure on the posterior capsule. However, this method can cause endothelial cell loss, an inflammatory response in the anterior chamber, and corneal edema, moreover it also does not resolve the issue of reverse pupillary block as well.…”

Two-stage or single-stage vitreoretinal surgery with phacoemulsification in patients with advanced proliferative diabetic retinopathy?

“…Для предотвращения сужения зрачка и поддержания необходимого мидриаза на протяжении всей операции было предложено вводить в переднюю камеру раствор адреналина или использовать ирис-ретракторы [6]. Tau Yu et al (2018) сообщили, что увеличенная глубина передней камеры на фоне авитрии позволяет производить удаление хрусталика в передней камере, поддерживая безопасное расстояние до эндотелия роговицы и уменьшая риск повреждения задней капсулы [24]. Таким образом, применение вышеуказанных технических приемов позволяет избежать специфических осложнений, характерных для ФЭК, на авитреальных глазах и обосновывает выполнение ФЭК в качестве альтернативной хирургии второго этапа после ВРХ при реабилитации пациентов с ПДР.…”