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Management of dropped nucleus in a tertiary eye centre

Poster Details

First Author: S.Georgoulas UK

Co Author(s):    F. Sabatino   V. Maurino                 

Abstract Details

Purpose:

The purpose of the study is to identify numbers of eyes managed for dropped nucleus at Moorfields Eye Hospital during an 18 months consecutive period and evaluate current management, complications and outcomes of those eyes.

Setting:

A retrospective audit analysis of all patients diagnosed with dropped nucleous complicating cataract surgery at Moorfields Eye Hospital UK between February 2012 and September 2014 was undertaken.

Methods:

Forty patients who had posterior vitrectomy and fragmatome lensectomy after cataract operation were identified from the MEH OPENEYES electronic patient records during the period September 2012-February 2014. The following data were collected using electronic and paper notes: a) Patients’ age, b) Operated eye, c) Description of the complication occurred during the cataract operation, d) procedures performed for management of dropped nucleus, e) Timing and position of IOL insertion, f) Pathology developed secondary to the dropped nucleus, g) Best corrected visual acuity 3 months after the posterior vitrectomy and fragmatome lensectomy. SPSS version 22 was used for the analysis of data.

Results:

Patients’ mean age: 73.8 y.o. (range 54-89). Pre-exsisting ocular co-morbidity. Main reasons of dropped nucleus; 72.5% posterior capsular (PC) rupture, 7.5% anterior capsular tear progressing to PC tear and 7.5% zonular dialysis. Main remedial procedures performed: posterior vitrectomy with fragmatome lensectomy and IOL (20%), without IOL (40%), with cryotherapy and IOL (15%), with ILM/ERM peel (5%). 15% of dropped nuclei were managed during the cataract operation and 85% in a second operation. The majority (67.5%) had IOL placed during cataract operation. IOL was mainly placed in sulcus (42.5%) and in AC (35%). The management did not lead to intra/postoperative complications in most cases (75%).

Conclusions:

Our study showed that managing complications of dropped nucleus, either during the cataract operation by converting it to posterior vitrectomy and fragmatome lensectomy, or in a second procedure, is safe and leads to good visual outcome. Most of cases, which did not achieve improvement of vision, had pre-existing pathology, which has affected the visual outcome. The placement of the IOL during the initial operation was preferred when possible in the majority of cases as it was considered safer.

Financial Disclosure:

NONE

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