Phacoemulsification in the anterior chamber: An alternative surgical technique in post-vitrectomy cataract

Objective: To evaluate the characteristics, safety and effectiveness of a modified technique of phacoemulsification in post-vitrectomy cataracts.

Methods: This retrospective clinical trial comprised 31 patients (31 eyes) with post-vitrectomy cataract, who had undergone phacoemulsification combined with intraocular lens implantation. An alternative surgical technique known as phacoemulsification in the anterior chamber was used for nucleus management in those cases. The following parameters were evaluated: best corrected visual acuity (BCVA), ocular inflammation, intraocular pressure, endothelial cell count and surgical complications.

Results: Three months after surgery, the BCVA improved significantly compared with that before surgery (Z=-10.547; p<0.05). There were no significant differences in IOP before and after surgery (Z=-0.474; p>0.05). There was a statistically significant postoperative decrease in endothelial cell densities (Z=-3.916; p<0.05). The mean endothelial cell loss was -8.71%. A little inflammatory response in the anterior chamber in 11 eyes and mild corneal edema in 8 eyes were observed on the first day after surgery, which subsided after a week. The posterior capsular opacification were observed in three eyes, two of which were denser, and the YAG laser was performed for posterior capsular incision. No obvious surgical complications occurred.

Conclusion: The modified technique of phacoemulsification, with phacoemulsification in the anterior chamber, is safe and effective to deal with post-vitrectomy cataracts.