Video Presentation

Changes in the vitreoretinal interface during an uneventful phacoemulsification

Video Details

First Author: P.Lopez Lizarraga SPAIN

Co Author(s):    F. March de Ribot   A. March de Ribot                          

Abstract Details



Purpose:

Posterior vitreous detachment (PVD) appears to be more common in individuals who have had cataract surgery, although there is not a proof of a cause and effect relationship. To share the experience we had in an uneventful cataract surgery and the changes we saw in the vitreoretinal interface during the phacoemulsification.

Setting:

University hospital, ophthalmology department

Methods:

Clinical and surgical case: A 47 years old patient presented a mild subcapsular cataract. The patient had myopia and astigmatism that corrected with contact lenses. A phacoemulsification was planned with a toric intraocular lens of 7,5 diopters.

Results:

Phacoemulsification was realized uneventfully, with slow motion technique. During the surgery a vitreous detachment was visible close to the nasal area. In the irrigation aspiration, when the cortex was completely removed we observed at the moment to extract the tip a complete posterior detachment moving in the central part. A toric intraocular lens was placed in the bag. In the follow up the patient developed 20/20 visual acuity with a posterior vitreous detachment. We think that the anterior segment pressure change at the moment to extract the irrigation aspiration tip produced a rough shift in the vitreous gel.

Conclusions:

The vitreous changes that lead to vitreous liquefication and then to PVD are age-related, and so is the relation with cataract and surgery. The cataract surgery can allow shifts in the vitreous gel and increase the odds of PVD. Biochemical changes in the vitreous gel occur following cataract surgery, and increase the likelihood of PVD, particularly if there is a rupture of the posterior capsule. Posterior vitreous detachment after cataract surgery has to be examined because of retinal detachment risk.

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