Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 7788
  • Home
  • Print this page
  • Email this page

   Table of Contents      
LETTER TO EDITOR
Year : 2007  |  Volume : 55  |  Issue : 6  |  Page : 487-488

Phacoemulsification and pars plana vitrectomy: A combined procedure


Vitreo Retinal Unit, Al-Bahar Eye Center, Ibn-Sina Hospital, P.O Box- 25427, Safat 13115, Kuwait

Correspondence Address:
Seemant Raizada
Vitreo Retinal Unit, Al-Bahar Eye Center, Ibn-Sina Hospital, P.O Box- 25427, Safat 13115
Kuwait
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.36500

Rights and Permissions

How to cite this article:
Raizada S. Phacoemulsification and pars plana vitrectomy: A combined procedure. Indian J Ophthalmol 2007;55:487-8

How to cite this URL:
Raizada S. Phacoemulsification and pars plana vitrectomy: A combined procedure. Indian J Ophthalmol [serial online] 2007 [cited 2020 Feb 19];55:487-8. Available from: http://www.ijo.in/text.asp?2007/55/6/487/36500

Dear Editor,

We read the article by Jain et al . [1] with interest. We congratulate the authors for their study and agree with them regarding the utility of the combined phacoemulsification and pars plana vitrectomy at the same sitting. Ours is a high volume retina unit and we are performing more than 50 similar combined procedures in a year. All our retina surgeons are proficient in phacoemulsification also. We would like to suggest few points to augment this fine study.

  1. The authors have not discussed the remedies for difficult capsulorrhexis due to absent or faint red reflex (due to retinal detachment or vitreous hemorrhage). Capsular staining with Vision Blue (D.O.R.C. International b.v. The Netherlands) is very useful in these cases. In some cases we switch to slit light in our operating microscope (OPMI VISU 210, Ziess) which also helps.
  2. It is true that phacoemulsification is difficult in previously vitrectomized eyes, especially in cases where gas was used because of absence of vitreous support. In silicon-filled eyes, there are two main problems. One is the appearance of emulsified oil through the zonules which interfere with visualization. At times, zonular dehiscence can even lead to unstable lens in which case capsular tension rings may have to be used. Second problem in silicone-filled eyes is the positive pressure of oil which pushes the posterior capsule up. This situation may be managed by keeping an anterior chamber maintainer in place. We agree that placing an intra ocular lens (IOL) prior to vitrectomy is a better option because after the globe is opened by way of sclerotomies and after fluid air exchange, gas or oil it would be difficult to place the IOL in the bag.
  3. One interesting observation in the study by Jain et al , was the use of hydrophobic acrylic IOLs in all the cases. Hydrophobic acrylic IOLs are less biocompatible in comparison to hydrophilic IOLs. They have a tendency to bioadhesiveness, hence more difficult to perform Nd: YAG laser capsulotomy later, if there is posterior capsular opacification and there are more chances of IOL damage during laser. [2] Moreover, if silicon oil is to be used then hydrophobic acrylic IOLs are not a good choice because silicon oil adheres to it more readily than to the hydrophilic IOLs. [2] This will make visualization of fundus difficult in postoperative follow-up.
  4. It would be interesting to know why sclerotomies were done 3.5 mm behind limbus in all the cases instead of standard 3.0 mm as is done in pseudophakic eyes.


 
  References Top

1.
Jain V, Kar D, Natarajan S, Shome D, Mehta H, Mehta H, et al. Phacoemulsification and pars plana vitrectomy: A combined procedure. Indian J Ophthalmol 2007;55:203-6.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.
Apple DJ, Issacs RT, Kent DG, Martinez LM, Kim S, Thomas SG, et al. Silicone oil adhesion to intraocular lenses: An experimental study comparing various biomaterials. J Cataract Refract Surg 1997;23:536-44.  Back to cited text no. 2
    



This article has been cited by
1 Cataract phacoemulsification after vitreoretinal surgery
Zhou, Q.-H., Li, Y.
Journal of Central South University (Medical Sciences). 2008; 33(11): 1053-1055
[Pubmed]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
References

 Article Access Statistics
    Viewed2004    
    Printed22    
    Emailed0    
    PDF Downloaded182    
    Comments [Add]    
    Cited by others 1    

Recommend this journal