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T. Iwase, T. Yoshita, K. Sugiyama; Clear Corneal Vitrectomy Combined With Phacoemulsification and Foldable Intraocular Lens Implantation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2249.
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We have invented a technique for the treatment of cataract and epi-retinal membrane (ERM) using a 25-gauge vitrectomy system through clear corneal ports.
Corneal side ports of 0.5 mm in width were made at 2, 4, 10 o’clock (and 8 o’clock in right eye). After a continuous curvilinear capsulorhexis (CCC) and a clear corneal tunnel of 3.0 mm in width were made from the 12 o’clock, phacoemulsification and a posterior CCC were performed. Then, an infusion cannula was inserted from the 8 o’clock port in right eye or the 4 o’clock in left eye, and the infusion line was started to acquire an appropriated resisting pressure. Then a 25-gauge vitreous cutter and a light guide were inserted from the 2 or 10 o’clock ports, and core vitrectomy was performed. After the ERM was removed using forceps, a viscoelastic substance was injected into the capsular bag and intra-ocular lens (IOL) was implanted into the capsular bag. Finally, all corneal incision wounds were hydrated and left sutureless, and closure of the wounds was confirmed.
We successfully implanted the IOL into the capsular bag in 7 consecutive eyes. There was no leakage of aqueous humor from the corneal wounds and no low IOP eyes after surgery. The inflammation in the anterior chamber seemed to be similar to the one after cataract surgery. There were neither any IOL dislocation nor retinal complication such as retinal detachment or vitreous hemorrhage.
Clear corneal incision vitrectomy caused shorter operating time and less postoperative ocular irritation than combined surgery with 25-gauge transconjuntival vitrectomy. Therefore, this procedure would be a good option for selected cased with cataract and vitreoretinal diseases.
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