Retina-Vitreous
2001 , Vol 9 , Num 3
CATARACT SURGERY AND SILICONE OIL REMOVAL THROUGH A SINGLE SCLERAL TUNNEL INCISION UNDER TOPICAL ANESTHESIA; SUTURELESS SURGERY
Uludağ Üniversitesi Tıp Fakültesi Göz Hast.
PURPOSE : Cataract is a frequent complication after silicone oil infusion. The authors evaluated the results of combined cataract extraction and transpupillary silicone oil removal through a single scleral tunnel incision in eyes that had undergone pars plana vitrectomy with silicone oil tamponade. METHOD : Fifteen of the 29 eyes were operated under topical anesthesia with Blumenthal mode "Mini-Nucleus" cataract extraction technique, and silicone oil was removed passively through planned posterior capsulorhexis via the scleral tunnel, followed by endocapsular intraocular lens (İOL) implantation. The operation was completed without any suturing. The remaining 1.4 eyes were similarly operated with the same cataract extraction technique, however silicone oil was classically aspirated actively through pars plana sclerotomies. All patients were operated on by the same surgeon. Results were evaluated by visual acuity measurement, operation time, and complications.
RESULTS : The transpupillary silicone aspiration group had significantly less vitreous hemorrhage (% 0 - % 28.6) and posterior capsule opasification (0%-21.4%), also the mean duration of the operation was significantly shorter in this group. Concerning postoperative recurrence of retinal detachment (13.3%-14.3%) and visual acuity outcome there was no significant difference between the two groups. Corneal decompansation or secondary glaucoma was not recorded in any case.
CONCLUSION : The combination of "Mini Nucleus" cataract extraction with transpupillary silicone oil removal compares favorably with the combination of silicone oil aspiration through pars plana sclerotomies. This combined technique allows the surgeon to perform the operation under topical anesthesia; no sutures are necessary. The intervention period is shorter and no posterior capsule opasification or vitreous hemorrhage develops. Keywords : Cataract surgery. Transpupillary silicone oil removal, Combined surgery
