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

Authors' reply


1 Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai - 400 031, India
2 Department of Retina, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai - 400 031, India
3 Department of Ophthalmic and Facial Plastic Surgery Orbital Diseases and Ocular Oncology, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai - 400 031, India

Correspondence Address:
Vandana Jain
Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai - 400 031
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.36501

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How to cite this article:
Jain V, Kar D, Natarajan S, Shome D, Mehta H, Mehta H, Jayadev C, Borse N. Authors' reply. Indian J Ophthalmol 2007;55:488

How to cite this URL:
Jain V, Kar D, Natarajan S, Shome D, Mehta H, Mehta H, Jayadev C, Borse N. Authors' reply. Indian J Ophthalmol [serial online] 2007 [cited 2019 Oct 18];55:488. Available from: http://www.ijo.in/text.asp?2007/55/6/488/36501

Dear Editor,

We thank the writer for the interest in our article [1] and the interesting points that have been raised.

  1. We agree with the writer that capsulorrhexis can be difficult at times, especially in cases of vitreous hemorrhage and no red reflex. In these cases, as suggested, trypan blue staining or endoilluminator in the anterior chamber can assist in the completion of a successful capsulorrhexis. [2]
  2. We would agree that phacoemulsification is difficult in previously vitrectomized eyes, especially in cases where gas was used because of absence of vitreous support. We have already emphasized the various issues such as extremely deep anterior chambers during phacoemulsification, zonular dehiscence, increased mobility of the posterior capsule and loss of nuclear fragments posteriorly in these cases. We resorted to the use of anterior chamber maintainers for such cases and had no additional complications during the surgery.
  3. It has been reported that fibrinous uveitis is more common in cases of phacovitrectomy than in cases of phacoemulsification alone. [3] Additionally, the occurrence of posterior capsular opacification (PCO) in combined surgeries is greater than reported with phacoemulsification alone, due to greater manipulation, longer operating times and greater postoperative inflammation. [4] The PCO rates and the postoperative inflammation have been reported to be lesser in cases of hydrophobic IOLs. [5] All this had been the basis for our usage of hydrophobic acrylic lenses in cases of phacovitrectomy.
  4. Three mm as well as 3.5 mm sclerotomies can be done in cases of phacovitrectomy. We have been routinely using sclerotomies 3.5 mm behind the limbus and have not faced any difficulties. A similar technique has been reported for cases of phacovitrectomies. [6]


 
  References Top

1.
Jain V, Kar D, Natarajan S, Shome D, Mehta H, Mehta H, Jayadev C, Borse N. Phacoemulsification and pars plana vitrectomy: A combined procedure. Indian J Ophthalmol 2007;55:203-6.  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.
Demetriades AM, Gottsch JD, Thomsen R, Azab A, Stark WJ, Campochiaro PA, et al . Combined phacoemulsification, intraocular lens implantation and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology. Am J Ophthalmol 2003;135:291-6.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  
3.
Hurley C, Barry P. Combined endocapsular phacoemulsification, pars plana vitrectomy and intraocular lens implantation. J Cataract Refract Surg 1996;22:462-6.  Back to cited text no. 3
[PUBMED]    
4.
Ling R, Simcock P, McCoombes J, Shaw S. Presbyopic phacovitrectomy. Br J Ophthalmol 2003;87:1333-5.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  
5.
Apple DJ, Peng Q, Visessook N, Werner L, Pandey SK, Escobar-Gomez M, et al . Surgical prevention of posterior capsule opacification. Part I: Progress in eliminating this complication of cataract surgery. J Cataract Refract Surg 2000;26:180-7.  Back to cited text no. 5
    
6.
Lam DS, Young AL, Rao SK, Cheung BT, Yuen C Y, Tang HM. Combined phacoemulsification, pars plana vitrectomy and foldable intraocular lens implantation. J Cataract Refract Surg 2003;29:1064-9.  Back to cited text no. 6
    



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