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Ege Üniv.Tıp Fak.Göz Hastalıkları A.D., İzmir Purpose: To present the visual results and complications in patients in whom nuclear fragments were dislocated into the vitreus cavity during phacoemulsification.
Methods: The data of 19 cases, ranging in age from 55 to 81 years, in whom nucleus drop was developed during phacoemulsification were retrospectively reviewed. Twelve cases underwent pars plana vitrectomy (PPV) + lensectomy. In four cases in whom nucleus was too hard, nucleus was extracted through the limbal incision with the use of perfluorocarbon liquids after PPV. In three cases, PPV could not have been performed due to various reasons. The timing of vitrectomy ranged from 1 to 6 weeks after nucleus drop had occured. In seven cases who were left aphakic at the first operation, posterior chamber intraocular lens (IOL) was inserted at the same session after PPV. Postvitrectomy follow- up period ranged from 1 week to 1 year.
Conclusion: Previtrectomy best- corrected visual acuities ranged from P+ P+ to 8/10. Only four cases had visual acuity of 2/10 or better. Postvitrectomy best- corrected visual acuities ranged from P+ P+ to 10/10, in eleven cases best corrected visual acuity was 2/10 or better. In all cases in whom uveitis or IOP greater than 25mmHg was present in the previtrectomy period, PPV caused resolving of these complications. In three cases retinal detachment was developed and in one case cystoid macular edema was detected during the follow-up period.
Comment: Dislocation of nuclear fragments into the vitreus cavity is a serious complication that develops during phacoemulsification. Although accompanying pathologies, like corneal edema, choroidal detachment and glaucoma, might postpone the secondary surgery, we could still get satisfactory anatomic and visual outcomes with vitreoretinal surgical procedures in these cases. Keywords : Phacoemulsification, nucleus dislocation, complication, pars plana vitrectomy, secondary IOL implantation