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 port 23 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.
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 port 23 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.
Entities:
Keywords:
complications of phacoemulsification; dislocated hard lens; dislocated lens; dislocated sclerotic lens; intravitreal nucleotomy; posterior segment nucleotomy
Authors: Yasha S Modi; Aliza Epstein; William E Smiddy; Timothy G Murray; William Feuer; Harry W Flynn Journal: Am J Ophthalmol Date: 2013-06-28 Impact factor: 5.258