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J.-M. Perone, P.-J. Bertaux, B. Batta, M. al Saoub, A. Robin, I. Allal, H. Mnasri; Is it Still a Challenge to Perform Cataract Surgery After Pars Plana Vitrectomy? Retrospective Study About 30 Cases. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5390.
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The authors attempt to list the possible difficulties met during 2.2mm microcoaxial incision cataract surgery, on previously vitrectomized eyes. All the analyzed cases were of important hardness, classified in rank 3 or 4 of cataract evolution.
from October 08 to October 09, 30 previously vitrectomized eyes (indication of vitrectomy was vitreous haemorrhages secondary to proliferative retinopathy, with temporarily silicone oil tamponade), are operated by 2.2mm coaxial microincision phacoemulsification, with the device Stellaris Bausch & Lomb, with final foldable IOL implantation, by the same surgeon. The patient’s characteristics were analysed, duration of intervention, types of IOL, evolution of visual acuity, the difficulties faced and possible complications.
The study is retrospective, involving 30 eyes of 22 men (73.33 %) and 8 women (26.66 %), the mean follow up time is about 6.4 months (ranging from 1 to 12 months), the average age of the patients is about 63,57 years (ranging from 47 to 79 years), the average duration of intervention is about 11,05 minutes (ranging from 8 to 20mn), the average power of IOL was 21,75 dioptres (ranging from 16 to 28 D), the percentage of final suture was 42 %. All the studied eyes were normally implanted, with foldable IOL in 29 cases (96.66 %) and in the sulcus ciliaris for 1 case (3.33 %). The average of preoperative visual acuity was equal to 0.07 (ranging from light perception to 0.4) and a postoperative visual acuity of 0.28 (ranging from light perception to 0.8). The main difficulties encountered during operation were: the absence or difficulties of pupillary dilatations in 5 cases (16.66 %) (which generally are secondary to ocular inflammation after previous vitrectomy), abnormal important zonular laxity in 2 cases (6.66 %) and an important zonular disinsertion forbidding a normal IOL implantation in 1 case (3.33%).
In our retrospective study of 2.2mm microaxial cataract surgery after pars plana vitrectomies: no serious complications were reported. All the operated eyes were able to be normally implanted. The main difficulties however were problems of pupillar dilatation or zonular laxity which will make realize a careful but nevertheless practicable surgery, without big difficulties in a great majority of the cases.
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