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Eugenia Oria, Jeremias G. Galletti, Pablo Chiaradia, Marcelo Zas; Anterior Segment Impact of 20G Three-port Pars Plana Vitrectomy in Phakic Eyes. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2595.
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To evaluate changes in anterior segment morphology and corneal endothelium after three-port pars plana vitrectomy in phakic eyes.
26 eyes from 26 phakic subjects who underwent three-port pars plana vitrectomy without complications for retinal pathology were evaluated before and 30 days after surgery with corneal specular microscopy (endothelial cell density, coefficient of size variation [polymegathism] and hexagonality [pleomorfism]) and Pentacam Scheimpflug tomography (mean power [Km] and astigmatism of anterior and posterior corneal surfaces, corneal pachymetry, anterior chamber depth [ACD] and volume [ACV]). Unoperated fellow eyes were studied as a control group. Student’s t test was used for comparison of means.
Silicon oil tamponade was used in 4 eyes and gas tamponade was used in 6 eyes. Corneal endothelial cell density change in operated eyes was greater than in control eyes (cells/mm2, -67 ± 23 vs -14 ± 15, p=0.04) at the 30-day followup. Changes in anterior Km (diopters, 0.20 ± 0.10 vs -0.07 vs ± 0.06, p=0.03), ACV (mm3, 14.2 ± 4.8 vs 3.1 ± 2.1, p=0.03) and ACD (mm, 0.19 ± 0.07 vs 0.03 ± 0.01, p=0.02) were also greater in the vitrectomy group. No statistically significant changes were detected in the other corneal variables explored when compared to control eyes.
The magnitude of the detected changes in endothelial cell density, anterior chamber morphology and anterior corneal curvature, although statistically significant, is not clinically relevant. Phakic eyes seem to bear minimum impact on anterior segment morphology and corneal endothelium from uneventful 20G pars plana vitrectomy.
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