Posters

The use of intraocular lens-as-a-glide in the management of posterior capsule rupture during phacoemulsification

Poster Details

First Author: A. Liaska GREECE

Co Author(s):    E. Makri   V. Dimopoulou   S. Stamelou   K. Andrianopoulou           

Abstract Details

Purpose:

The conventional management of posterior capsule rupture(PCR) during cataract operation consists of prevention of mixture cortical matter with vitreous,dry aspiration and anterior vitrectomy,if required.In addition,low flow rate, high vacuum,and low ultrasound are advocated if a posterior capsule tear occurs during phacoemulsification. The use of intraocular lens (IOL)-as-a-glide passed behind lens fragments to cover the capsular defect has been presented relatively recently as an additional tool to treat this complication.The purpose of the study is to compare the intraoperative complications and early(up to the 3rd postoperative month) postoperative course between the conventional and the IOL-as-a-glide way in the management of PCR.

Setting:

Department of Ophthalmology, General Hospital of Lamia, Lamia, Greece

Methods:

Retrospective chart review.2175 charts of patients having a cataract operation during the years 2013-2015 in General Hospital of Lamia were reviewed.Among them,17 cases(17 patients,13 men and 4 women,61-87 years-old)with posterior capsule tear during phacoemulsification(i.e. with remaining lens fragments) were identified. Five cases were treated with the conventional way and 12 cases with the additional use of posterior chamber IOL-as-a-glide. The correlation between the method used and age, sex, use of posterior chamber intraocular lens, need for vitrectomy, vitreous wick syndrome, posterior migration of lens material and visual acuity up to the 3rd postoperative month were examined with non-parametric Spearman correlation.

Results:

Age,female sex and visual acuity up to the 3rd postoperative month were positively correlated with the use of IOL-as-a-glide, although not statistically significant (p=0.5419, p=0.1582 and p=0.3777, respectively). Vitreous prolapse requiring vitrectomy and posterior dislocation of nuclear fragments had a significant negative correlation with the use of IOL-as-glide (p= 0.0012 & p=0.0208, respectively), while vitreous wick had a non-statistically significant negative correlation (p=0.8793). The implantation of posterior chamber IOL showed a significant positive correlation (p=0.0179) with the use of IOL-as-glide. There was one case of retinal detachment in a conventionally treated patient.

Conclusions:

The use of IOL-as-glide allows for better compartmentalization of the eyeball interior and protects of serious complications (posterior dislocation of lens fragments and vitreous prolapse), although it has not shown a significant favorable effect on the early postoperative visual acuity. Long term results will further elucidate the effects of this technique on the postoperative course of eyes with posterior capsule tear during phacoemulsification.

Financial Disclosure:

NONE