Purpose: Accidental rupture of the vitreous face with incarceration of vitreous into the surgical wound is a major cause of decreased visual acuity following cataract surgery. Vitreous loss increases the risk of cystoid macular edema, retinal detachment and pupil deformity. We compared various techniques of vitreous loss management in resident cataract surgery. Methods: A consecutive series of 108 cataract procedures with vitreous loss among 18 residents over a 27 month period were studied. Vitrectomy with methylcellulose sponges (group 1) anterior vitrectomy performed through the original corneal-scleral wound (group 2) and combined anterior and pars plana vitrectomy using a two port system (group 3) were evaluated. Patients were evaluated for at least 3 months. Result: Of 108 cataract procedures with vitreous loss, 56% occurred with phacoemulsiflcation techniques. Two percent of 108 patients had sponge clean up, 79% underwent anterior vitrectomy and 18% had pars plana vitrectomy. Fifty-eight percent of all patients had sufficient capsular support for posterior chamber lens insertion and 37% had anterior chamber lens implants. Five patients were left aphakic. Forty-five percent had best corrected visual acuity of 20/40 or better at 3 month follow-up. There was no statistically significant difference in visual outcome in cases managed with anterior vs. posterior vitrectomies. Conclusion: Visual outcome of 20/40 or better can be achieved with meticulous anterior or pars plana vitrectomy following accidental vitreous loss during resident cataract surgery.
|Original language||English (US)|
|Journal||Investigative Ophthalmology and Visual Science|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Sensory Systems
- Cellular and Molecular Neuroscience