· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre a...· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port23 G pars plana vitrectomy and perfluorocarbon liquid(PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL,Fluid Air Exchange was done in all the cases and surgery completed uneventfully.·RESULTS: Best corrected visual acuity(BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.·CONCLUSION: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.展开更多
Purpose:To evaluate the efficacy of intravitreal phacoemulsification in the removal of dislocated crystalline lenses.Methods:Twenty-two cases (22 eyes) with posterior dislocated lens induced by ocular trauma or capsul...Purpose:To evaluate the efficacy of intravitreal phacoemulsification in the removal of dislocated crystalline lenses.Methods:Twenty-two cases (22 eyes) with posterior dislocated lens induced by ocular trauma or capsule rupture during phacoemulsification between January 2008 and December 2010 were retrospectively analyzed in this study.Total vitrectomy was first performed through standard closed three-port incisions at the pars plana,and dislocated lenses were removed using the phacoemulsification tip without the silicone sleeve.Extraction of intraocular foreign body,endolaser retinal photocoagulation and intraocular lens implantation were performed simultaneously.Visual acuity,intraocular pressure (IOP) and postoperative complications were assessed over 1 to 3 months of follow up.Results:All dislocated lenses were extracted without severe complication.The final corrected visual acuity was ≥ 6 /15 in 7 cases,6 /100-6 /18 in 5 cases and ≤ 6 /120 in 10 cases,a significant improvement over preoperative values (P <0.05).The IOP in 10 cases (10 eyes) with secondary glaucoma was < 21 mmHg post-operatively.Intraocular foreign bodies in 3 eyes were removed.Nine patients (9 eyes) underwent intraocular lens implantation.No instances of retinal detachment,retinal hemorrhage or scleral wound burn were observed after surgery.Conclusion:Intravitreal phacoemulsification combined with vitrectomy yielded good efficacy and safety in the treatment of posteriorly dislocated lens.It may be an alternative to phacofragmentation in the treatment of posteriorly dislocated lenses.展开更多
AIM: To evaluate the outcomes of "concurrent vitrectomy" to retrieve dislocated lens fragment during phacoemulsification.METHODS: In a retrospective, observational case series, data of patients who underwent...AIM: To evaluate the outcomes of "concurrent vitrectomy" to retrieve dislocated lens fragment during phacoemulsification.METHODS: In a retrospective, observational case series, data of patients who underwent "concurrent" pars plana vitrectomy(PPV) for dislocated lens fragments between the period 2000 and 2008 were reviewed. Data collected included patient demographics, pre-operative visual acuity, intra-operative occurrence of retinal breaks, duration of follow up, post-operative intraocular pressure, final best-corrected visual acuity(BCVA),presence of cystoid macular edema(CME) and occurrence of rhegmatogenous retinal detachment(RRD).· RESULTS: A total of 58 eyes of 58 patients were included in the study. At 12 mo the mean postoperative BCVA was log MAR 0.17(20/30) with a range of log MAR0 to 0.69(20/20 to 20/100), with 96.6%(56/58) of patients showing post- operative improvement in visual acuity(P =0.005). None of the patients developed postoperative retinal detachment, endophthalmitis or non-resolving uveitis at 12 mo.CONCLUSION: Our study results suggest concurrent PPV for retained lens fragments after cataract surgery is beneficial and may decrease the risk of glaucoma and prevent development of RRD.展开更多
Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Metho...Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.展开更多
文摘· AIM: To describe a new surgical technique for managing dislocated sclerotic cataractous lens.· METHODS: Six patients with advanced posteriorly dislocated cataracts were operated at a tertiary care centre and analyzed retrospectively. After standard 3 port23 G pars plana vitrectomy and perfluorocarbon liquid(PFCL) injection, the dislocated white cataract was held with occlusion using phaco fragmatome and then chopped into smaller pieces with a sharp tipped chopper using 25 G chandelier endoilluminator. Each piece was emulsified individually. Following aspiration of PFCL,Fluid Air Exchange was done in all the cases and surgery completed uneventfully.·RESULTS: Best corrected visual acuity(BCVA) in all the patients was better than 6/12 after one month of follow up. No serious complications were noted till minimum 6mo of follow up.·CONCLUSION: Four port posterior segment nucleotomy with a chandelier endoilluminator, fragmatome and a chopper appears to be a safe, easy and effective procedure for managing dislocated sclerotic cataractous nuclei. Ultrasonic energy used and adverse thermal effects of the fragmatome on the sclera may be lesser.
文摘Purpose:To evaluate the efficacy of intravitreal phacoemulsification in the removal of dislocated crystalline lenses.Methods:Twenty-two cases (22 eyes) with posterior dislocated lens induced by ocular trauma or capsule rupture during phacoemulsification between January 2008 and December 2010 were retrospectively analyzed in this study.Total vitrectomy was first performed through standard closed three-port incisions at the pars plana,and dislocated lenses were removed using the phacoemulsification tip without the silicone sleeve.Extraction of intraocular foreign body,endolaser retinal photocoagulation and intraocular lens implantation were performed simultaneously.Visual acuity,intraocular pressure (IOP) and postoperative complications were assessed over 1 to 3 months of follow up.Results:All dislocated lenses were extracted without severe complication.The final corrected visual acuity was ≥ 6 /15 in 7 cases,6 /100-6 /18 in 5 cases and ≤ 6 /120 in 10 cases,a significant improvement over preoperative values (P <0.05).The IOP in 10 cases (10 eyes) with secondary glaucoma was < 21 mmHg post-operatively.Intraocular foreign bodies in 3 eyes were removed.Nine patients (9 eyes) underwent intraocular lens implantation.No instances of retinal detachment,retinal hemorrhage or scleral wound burn were observed after surgery.Conclusion:Intravitreal phacoemulsification combined with vitrectomy yielded good efficacy and safety in the treatment of posteriorly dislocated lens.It may be an alternative to phacofragmentation in the treatment of posteriorly dislocated lenses.
文摘AIM: To evaluate the outcomes of "concurrent vitrectomy" to retrieve dislocated lens fragment during phacoemulsification.METHODS: In a retrospective, observational case series, data of patients who underwent "concurrent" pars plana vitrectomy(PPV) for dislocated lens fragments between the period 2000 and 2008 were reviewed. Data collected included patient demographics, pre-operative visual acuity, intra-operative occurrence of retinal breaks, duration of follow up, post-operative intraocular pressure, final best-corrected visual acuity(BCVA),presence of cystoid macular edema(CME) and occurrence of rhegmatogenous retinal detachment(RRD).· RESULTS: A total of 58 eyes of 58 patients were included in the study. At 12 mo the mean postoperative BCVA was log MAR 0.17(20/30) with a range of log MAR0 to 0.69(20/20 to 20/100), with 96.6%(56/58) of patients showing post- operative improvement in visual acuity(P =0.005). None of the patients developed postoperative retinal detachment, endophthalmitis or non-resolving uveitis at 12 mo.CONCLUSION: Our study results suggest concurrent PPV for retained lens fragments after cataract surgery is beneficial and may decrease the risk of glaucoma and prevent development of RRD.
文摘Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.
