J Korean Ophthalmol Soc.  2020 May;61(5):500-505. 10.3341/jkos.2020.61.5.500.

Surgical Outcomes of Intravitreal Torsional Phacoemulsification for Dropped Lens Fragments during Cataract Surgery

• Kim S
• Lee S

• KMID: 2500722
• DOI: http://doi.org/10.3341/jkos.2020.61.5.500

Abstract

Purpose
To evaluate the surgical outcomes of microincision pars plana vitrectomy (PPV) and intravitreal torsional phacoemulsification in eyes with dropped nuclear fragments following complicated cataract surgery.
Methods
A retrospective analysis of 22 eyes of 22 patients who underwent microincison PPV for lens fragments dropped into the vitreous cavity during cataract surgery between January 2014 and December 2017 with a minimum 6-month follow-up was performed. Pre- and postoperative visual acuity, and intra- and postoperative complications (retinal detachment, retinal tear, cystoid macular edema, and thermal burns of the sclerotomy site) were recorded.
Results
The study included 17 males and 5 females. The mean age of patients was 71.3 ± 8.2 years. The mean interval between cataract surgery and PPV was 0.4 ± 0.8 days, and all PPV procedures were performed within 3 days after cataract surgery. The mean best-corrected visual acuity (LogMAR) was 1.37 ± 0.79 in the preoperative state, which improved significantly to 0.21 ± 0.15 in the postoperative state (p < 0.001). No complication such as thermal burns of the sclerotomy site and retinal damage due to lens fragments occurred during intravitreal torsional phacoemulsification. Postoperative cystoid macular edema occurred in two eyes, which was managed medically. No retinal detachment was noted.
Conclusions
Microincision PPV and intravitreal phacoemulsification using a torsional phacoemulsification probe for lens fragments dropped into the vitreous cavity during cataract surgery was a safe and effective method, which resulted in visual improvement without any complication directly attributable to the probe.

Keyword

Cataract; Phacoemulsification; Vitrectomy