Abstract
Introduction: :
Retinal detachment after Phaco CE with posterior capsular defectObjective:References to the likelyhood of retinal detachment after capsular tear are unexpectedly unproductive and often come from very small cohorts. In the literature from the early nineties of the last century the amotio-rate after posterior capsular rupture with 5 - 8% becomes given. Because the given literature evaluated OPs from the 80s often still in ECCE and in case of complications wedge swab vitrectomy was done, this investigation about the amotio-rate with modern complication management should give conclusions.Material and
Methods: :
January 98 and December 08 in the Detmold Eye Clinic performed planned Phaco-CE’s be searched on the basis of OP book for use of a vitrectomy. In cases in which with the OP a vitrectom had been used OP report and patient recordings were evaluated and thus different reasons were identified for (mainly anterior) vitrectomy. Then in all cases of vitrectomy with Phaco CE the referring ophthalmologists were written up and asked for finding information with regard to retinal detachment, lens dislocation, visual acuity and date of the last investigation. In all cases in which on this way no data from 09 were available patients were contacted by telephone and questioned.
Results: :
From 1/98 to 12/08 32.857 cases of planned Phaco-CE's were evaluated. 365 cases (1.11%) in which a vitrectom was used during the operation were found, under it: Capsule ruptures 257 (0.78%), primary zonulolysis 73 (0.22%), changes into ICCE 9 (0.03%), PPV 19 (0.06%), other 6 (0.02%). In 365 cases 12 retinal detachments had occured, under it 8 after PC-rupture, 2 to after zonulolysis and 1 after ICCE and 1 after PPV. On average of all cases the amotio-rate amounted to 3.29%, after posterior capsule rupture or zonulolysis 3.03%, against it to PPV or ICCE 6.89%.
Discussion: :
In our patients we found less retinal detachments than the literature allows to suppose, as long as a complication limits itself mainly to the anterior ocular segment: With primary zonulolysis 2.74% (in 2 of 73 cases), with posterior capsular defects 3.11% (in 8 of 257 cases). If a PPV was combined against it with a Phaco CE or necessarily, the amotio-rate amounted to 5.25% (one of 19 cases), by change in an ICCE even 10% (one of 10 cases). The clean removal of all possible causes for vitreous body traction seems to influence the likelyhood for a detached retina in the later course favourably.
Keywords: cataract • clinical (human) or epidemiologic studies: prevalence/incidence • retinal detachment