Posters

Cataract surgery in eyes filled with silicone oil: clinical and surgical features

Poster Details

First Author: D.Gouider TUNISIA

Co Author(s):    H. Zgolli   S. Mabrouk   L. Nacef              

Abstract Details

Purpose:

To describe the clinical features of siliconic cataract and discuss the surgical particularities of phacoemulsification on a silicone filled eye.

Setting:

Institute Hedi Rais of ophthalmology, Department A.

Methods:

Descriptive prospective non comparative study was conducted on 120 patients treated in department A of Hedi Rais Institute of Ophthalmology of Tunis. Our study analysed consecutive case series of patients with eyes filled with silicone oil undergoing cataract surgery. Phacoemulsification with posterior chamber intraocular lens implantation was conducted with or without concurrent silicone oil removal.

Results:

In this study, 121 eyes from 120 patients were included. The cataract was nuclear and posterior pre-capsular in 98% of cases. The remaining 2% were moderately dense nuclear cataracts. The time’s onset of cataract was 4 months on average. In 32 eyes (26.4%) with evident silicone oil microemulsification or open angle glaucoma associated with silicone oil, the silicone oil was removed prior to phacoemulsification through a pars plana incision and no cases of posterior capsular rupture occurred during the subsequent cataract surgery. In the remaining 89 eyes, phacoemulsification was performed with silicone oil in the vitreous cavity. In these eyes, the rate of posterior capsular rupture was 5/89 (5,61%) and the rate of migration of silicone oil into the anterior chamber through an apparently intact posterior capsule was 2/89 (2,24%). In 116 eyes (95,86%) an intraocular lens was inserted into the capsular bag, in 4 eyes (2.5%) an intraocular lens was inserted into the sulcus and in 1 eye (0.8%) an iris-clipped implant was performed.

Conclusions:

The increased risk of intraoperative complications during cataract surgery in vitrectomized eyes is well established. It may be associated with traumatized lenses during vitrectomy, zonal fragility, or intraoperative moysis. The buoyancy of the silicon oil may result in elevation of the posterior capsule, additional instability of the anterior chamber, and an increased risk of posterior capsule rupture. According to the literature, the incidence of posterior capsule rupture during phacoemulsification in vitrectomized eyes has been reported to be between 1.4 and 10%. Thus, siliconoilremovalprior to PKE still recommanded.

Financial Disclosure:

None