Posters

Small-incision cataract extraction and intraocular lens implantation in nanophthalmic eyes

Poster Details

First Author: G.Siasou GREECE

Co Author(s):    M. Dari   O. Diavati                 

Abstract Details

Purpose:

Cataract surgery in nanophthalmic eyes is technically challenging with a high risk of intraoperative and post-operative complications, such as uveal effusion, choroidal haemorrhage, aqueous misdirection and malignant glaucoma. The purpose of this retrospective study is to evaluate the complication rate after small-incision phacoemulsification and foldable posterior chamber intraocular lens implantation in a small series of nanophthalmic eyes.

Setting:

Moorfields Eye Hospital, UK.

Methods:

Eight eyes of six patients with a mean age of 68 years (range 56-77) were included in this retrospective study. Nanophthalmos was defined as axial length (AL) less than 20 mm. Mean AL was 18.93mm and mean anterior chamber depth was 2.30mm. All eyes underwent bimanual small-incision phacoemulsification and foldable posterior chamber lens implantation by an experienced surgeon under subtenon’s block followed by pressure eyepad for 10 minutes and without preoperative administration of intravenous hyper-osmotic solution. Iris-hooks were inserted in 2 eyes with inadequate pupil dilation and a capsular tension ring was inserted in 1 eye with zonular dialyses.

Results:

The best corrected visual acuity improved and the intraocular pressure remained stable or reduced in all 8 eyes post-operatively. Seven out of the total of eight eyes had an uneventful procedure, while 1 eye had zonular rupture during the surgery. Post-operatively 6 eyes had a smooth recovery, 1 eye presented prolonged corneal oedema and 1 eye developed mild iritis. All post-operative complications were successfully resolved with pharmacotherapy alone. No further complications occurred over a 3 month follow-up period.

Conclusions:

The results indicate that, although challenging, small-incision cataract surgery in nanophthalmic eyes is safe and diminishes the need for prophylactic sclerotomies. With reasonable preoperative planning, awareness of the potential complications and a rigorous surgical technique cataract surgery can be performed in these high-risk patients with a low incidence of complications and yield beneficial effects not only on their visual acuity, but also on the intraocular pressure.

Financial Disclosure:

None