Posterior Capsule Rupture Management Using Single-Port Pars Plana Vitrectomy
Purpose
More anterior chamber turbulence observed during conventional anterior vitrectomy through corneal incision. Alternatively single port pars plana vitrectomy (1 PPV) can be performed and this study is to evaluate the safety, effectiveness and outcome of 1 PPV to manage posterior capsule rupture during routine phacoemulcification.
Methods
Retrospective analysis of interventional case series.
When PCR was noted anterior chamber filled with viscoelastic and supplementary subtenon anesthesia was given on Topical cases. Single pars plana incision made with 20 gauge MVR knife to perform triamcinolone assisted anterior vitrectomy. Intraocular lens placed in the bag or in to sulcus and vitrectomy port was closed with 8-0 Polyglactin (Vicryl) suture. Intracameral Moxifloxacin with routine wound hydration done.
Data collected on patient demographics, complications and outcome during follow up period for one to three months.
Results
12 Eyes of 11 patients. PCR noted on 4 Polar Cataracts, 4 with Zonular dehiscence, 2 with routine phaco and 2 on patient with phacolytic Glaucoma.
No major surgical complications noted during procedure. All anterior chambers were cleared with no vitreous. All eyes had lens implantation except one case with phacolytic glaucoma.
Corneal haze noted on post operative day 01 on 4 cases and all were cleared at post operative 1 week except for one case with phacolytic glaucoma
Intraocular pressure was normal for follow up for two to three months except one eye with phacolytic glaucoma.
Conclusion
Conventional anterior vitrectomy is done using corneal wound assisted and it creates more anterior chamber turbulence and often it leads to residual vitreous in anterior chamber.
Single port pars plana vitrectomy seems to be very safe and effective way to manage PCR during routine phacoemulcification surgery. Because this is small case series it will need further studies.