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Treating misdirection syndrome in nanophthalmic eyes by creating hole in lens capsule and performing anterior vitrectomy through anterior chamber

Poster Details

First Author: Y.Kiuchi JAPAN

Co Author(s):    R. Toda                    

Abstract Details


To determine the effectiveness of iridectomy, capsulotomy, and anterior vitrectomy with a 25 gauge vitreous cutter through the anterior chamber (AC) to treat the misdirection syndrome in nanophthalmic eyes.


Non-comparative Case series at Hiroshima University Hospital


Four consecutive patients with the nanophthalmic misdirection syndrome after successful cataract surgeries underwent capsulotomy and anterior-vitrectomy through a peripheral iridectomy from the anterior chamber. The best-corrected visual acuity (BCVA), intraocular pressure (IOP), and anterior and posterior segment findings were recorded before and after the surgery.


A resolution of the aqueous misdirection was achieved in all cases. No recurrences except in one eye were observed after a mean follow-up of 42.4�Â�± 18.8 months (range, 21�â�€�“64 months). The mean IOP before the anterior vitreous and capsule surgery was 28.7 �Â�± 4.4 mmHg which was reduced to 13.7 �Â�± 1.3 mmHg at final visit. All but one patient who had uveal effusion maintained their BCVA. Scleral resection for uveal effusion and trabeculectomy for residual high IOP were useful.


Iridectomy, lens capsulotomy, and anterior vitrectomy using 25 gauge vitreous cutters through the anterior chamber to create a communication between anterior and posterior chamber is an alternative option in the treatment of patients with nanophthalmic misdirection syndrome.

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