Abstract
Purpose :
To evaluate the outcomes of prophylactic pars plana vitrectomy (PPV) prior to phacoemulsification in eyes with shallow anterior chambers due to various types of glaucoma.
Methods :
All patients who underwent prophylactic PPV with cataract extraction in eyes with shallow anterior chambers due to various types of glaucoma, between February 2012 and January 2014, at the New York Eye and Ear Infirmary were identified. A retrospective analysis was performed. Patient charts were reviewed for cataract grade, comorbid conditions, concurrent surgeries, intra-operative and long-term complications, need for second surgery, ocular biometry parameters, IOP, and corneal clarity.
Results :
8 eyes of 7 patients were analyzed. All eyes had shallow anterior chambers due to various types of glaucoma (chronic angle closure glaucoma n=4, acute angle closure n=1, phacomorphic glaucoma n=1, and traumatic cataract/glaucoma n=2). Average anterior chamber
depth was 2.29+/-0.18 mm prior to surgery. Average IOP prior to surgery was 29+/-14 mmHg, and decreased to 18+/-13 mmHg at 1 month post-operative visit. 6 of 8 eyes (75%) underwent uneventful cataract surgery with IOLs successfully placed in the capsular bag. 2 eyes had ruptured posterior capsules during the cataract surgery and were initially left aphakic. Both of these eyes eventually had successful placement of a secondary IOL. There was no incidence of retinal detachment. In 7 of 8 eyes, corneal edema resolved by post-operative week 3. One eye required corneal transplant for corneal decompensation.
Conclusions :
Risks associated with phacoemulsification can increase when surgery is performed in eyes with shallow anterior chambers, including endothelial cell loss, corneal decompensation, ruptured posterior capsule, iatrogenic iris damage, wound burn, etc. Prophylactic PPV may be considered in eyes with shallow anterior chambers to mitigate these risks.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.