Posters

Vitrector-assisted capsulotomy in complex case scenarios: a novel technique

Poster Details

First Author: D.Megur INDIA

Co Author(s):    B. Megur                    

Abstract Details

Purpose:

Capsulorrhexis is challenging in complex cases with fibrotic and calcifed anterior capsules commomly seen in traumatic and complicated cataracts in young patients, and hypermature cataracts & eyes with loose zonules in the elderly. These fibrotic capsules are difficult to tear, cut and will impart more stress on the zonules while tearing and also have an increased risk of peripheral extension. Purpose of this study is to report and analyze a new technique of using a high speed vitreous cutter for performing anterior capsulotomies in these complex case scenarios.

Setting:

A private eye hospital Megur Eye Care Centre , situated in Karnataka a southern state in India.

Methods:

This was a prospective study involving 30 eyes spanning a period of 2years.comprising of traumatic cataracts, senile hypermature cataracts with calcified capsules eyes, and Intumuscent cataracts. All the patients underwent vitrector assisted anterior capsulotomy using a high-speed 23 g vitrector followed by phacoemulsification of the nucleus and IOL implantation. The intra-operative events were documented. The ability of the capsulotomy margins to withstand the maneuvers during nucleus management and IOL implantation were noted. All the patients underwent comprehensive post op evaluation over a period of 3 months.

Results:

30 eyes. Traumatic Cataracts with fibrotic or Capsules -14 eyes., Senile Hypermature cataracts with calcified capsules or weak zonules - 10 eyes., Intumuscent cataracts – 6 eyes Vitrector assisted Capsulotomy was performed in all the 30 eyes, supplemented by forceps when deemed necessary, Radial extension of the capsulotomy margins was noted in one eye. 3 eyes with traumatic Cataracts had co –existing posterior capsular defects and required Anterior Vitrectomy.1eye had iris injury during the procedure. IOL could be placed in the bag in 29 eyes & in 1 eye the IOL was placed in the sulcus

Conclusions:

The Vitreous cutter is a useful tool to perform adequate sized capsultomies with reasonable strength in complex case scenarios. The Vitrector is easily accessible, efficient ,cost effective and an excellent alternative to costly devices like the Femto laser for managing these difficult capsules.The High-speed vitreous cutter cuts the capsule without pulling it; hence little stress is imparted on the zonules while performing the capsultomy. The vitreous cutter assissted capsulotomy margins demonstrated reasonable strength to withstand moderate stress forces encountered during routine phaco manoeuvres, IOL Insertion, IOL dialing and CTR insertions

Financial Disclosure:

None