Clinical outcomes of sleeveless phacotip assisted levitation of dropped nucleus

Br J Ophthalmol. 2014 Oct;98(10):1429-34. doi: 10.1136/bjophthalmol-2013-304737. Epub 2014 Feb 11.

Abstract

Background/aim: To demonstrate the feasibility of a sleeveless phacotip-assisted approach to levitate dropped nucleus.

Methods: This single-centre, retrospective, interventional, non-comparative case series reviewed the medical records of 34 eyes of 34 patients. Corrected and uncorrected distance visual acuity (CDVA, UDVA), early and late postoperative complications and ultrasound biomicroscopic (UBM) evaluation of the sclerotomy site was analysed.

Results: At 18 months follow-up, the mean postoperative UDVA and CDVA in Snellen's decimal equivalent was 0.42 ± 0.16 and 0.91 ± 0.2, respectively. There was a significant improvement in the UDVA (p=0.001) and CDVA (p=0.002). Nucleus drop occurred following intraoperative posterior capsular rupture in 25 eyes (73.5%), zonular weakness in 5 eyes (14.8%) and post-trauma in 4 eyes (11.7%). In the early postoperative period, corneal oedema was seen in 2 eyes, pigment dispersion in 3 eyes and vitritis in 2 eyes. There was loss of CDVA in 1 (2.9%) eye due to persistent cystoid macular oedema. UBM did not reveal any vitreous incarceration into the sclerotomy site.

Conclusion: Dropped nucleus was successfully levitated into anterior chamber with this technique, resulting in a significant visual outcome with a favourable complication rate.

Keywords: Lens and zonules; Posterior Chamber; Retina; Treatment Surgery; Vitreous.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications*
  • Lens Subluxation / etiology
  • Lens Subluxation / surgery*
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects
  • Phacoemulsification / instrumentation
  • Phacoemulsification / methods*
  • Posterior Capsular Rupture, Ocular / etiology
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy
  • Vitreous Body / pathology