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Treatment of nuclear fragments dislocation during phacoemulsification by 23 g sutureless vitrectomy and implantation pc IOL
First Author: M. Stamenkovic SERBIA
Co Author(s): Z. Zikic P. Aleksandra N. Nikitovic A. Bajic J. Milic M. Popovic
Estimation of results and complications of sutureless 23G vitrectomy with PC IOL implantation in dealing with nucleus or parts of nucleus prolapse during phacoemulsification.
Eye Clinic University Medical Center Zvezdara, Belgrade, Serbia
Fourteen patients with nucleus or a part of nucleus prolapse during phacoemulsification have been operated in our Clinic in the period of 2015-2020. Average age of this group was 74 (55-86). Preoperative visual acuity was ranged from HM to 3/60. Sutureless 23G pars plana vitrectomy with PC IOL implantation, was performed in all cases. Posterior chamber intraocular lens implantation was made during cataract surgery in 9 eyes. Vitrectomy was preformed immediately after cataract surgery in 5 eyes also with PC IOL implantation. Follow-up period was 11,5 (6-22) months.
In the group with vitrectomy and implantation PC IOL, performed immediately during cataract surgery visual acuity was better than 0,5 in 7 eyes (77.8%), and less than 0,1 in one eye (11%). In the group with vitrectomy and implantation PC IOL, performed after cataract surgery, as the second act, visual acuity was higher than 0,3 in 5 eyes (60%), 0,1-0,5 in 1 eye(20%) and up to 0,1 in one eye (20%). Secondary glaucoma and uveitis were more often in the second group but vitrectomy solved them.
Nuclear fragments dislocation in the vitreal cavity is serious complication of phacoemulsification. Sutureless 23G pars plana vitrectomy with implantation PC IOL, performed in the same act as a cataract surgery resulted in better postoperative visual acuity and less complications because of early removal nuclear fragments or nucleus. Despite of associated pathology like corneal oedema and secondary glaucoma, sutureless vitreoretinal surgery showed satisfactory anatomical and functional result and shorter postoperative recovery.
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