[Pars-plana vitrectomy with anterior chamber infusion via a paracentesis in pseudophakic eyes].

BACKGROUND: More than 50% of vitrectomies are performed in pseudophakic eyes. There is free communication between the anterior segment of the eye and the vitreous cavity through the zonular fibres of the lens. This means it is possible to use a primary anterior chamber infusion for pars-plana vitrectomy.
METHODS: For some years, therefore, we have used an anterior chamber approach for the infusion cannula when carrying out such simple vitreo-retinal procedures as silicone oil removal or macular pucker peeling in pseudophakic eyes.
RESULTS: In all eyes the anterior chamber access was placed via a corneal paracenthesis and during all vitrectomies it was held in place by corneal tissue tone with no need for suturing. Secure wound closure was also achieved without suturing by simply swelling the paracentesis. Conventional sclerotomies were closed with absorbable sutures. During vitrectomy the infusional flow was sufficient to ensure adequate intraocular pressure regardless of intraocular lens type and diameter.
CONCLUSIONS: In pseudophakic eyes the anterior chamber infusion approach by way of a paracentesis is a safe way of reducing surgical trauma during vitrectomy. It must, however, be borne in mind that when an endotamponade is applied it is necessary to switch the infusion to one of the sclerotomies.