Vitrector-Assisted Anterior Capsulotomy in Complex Cataract Cases Analysis
Purpose
To report and analyze the technique of using a vitreous cutter for performing anterior capsulotomy in complex case scenarios.
Methods
This is a prospective study involving 20 eyes, which underwent a vitrector assisted anterior capsulotmy in complex case scenarios. 8 eyes were traumatic cataracts with a fibrotic capsule of which 3 had zonular dehiscence, 6 eyes were senile hypermature cataracts with fibrosed and calcified anterior capsules, 6 eyes were phacomorphic glaucomas. Intraoperative events were documented. The patients underwent comprehensive examinations during follow up over a period of 3 months.
Results
Vitrector assisted circular opening could be achieved in 18 eyes. Radial extension was noted in 3 eyes and anterior vitrectomy was needed in 4 eyes. In 12 eyes IOL could be placed in the capsular bag and in 8 eyes IOLs were implanted in the ciliary sulcus. Best corrected Visual acuity of 6/12 or better could be achieved in 16 eyes.
Conclusion
Vitrector cuts the fibrotic capsule rather than stretching it, thus inducing minimal zonular stress in complex cataract cases Hence the Vitreous cutter is a safe and an efficient tool to make a circular anterior capsular opening in complex cases with fibrosed capsules and loose zonules.