| 발표일자: |
2019년 11월 1일(금)~3(일) |
| 발표번호: |
P(e-poster)-395 |
| 발표장소: |
B3 Parking Area
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| Challenging managements in cataract surgery in vitrectomized eye |
| Department of Ophthalmology Faculty of Medicine University of Indonesia, Cipto Mangunkusumo Kirana Hospital |
| Syska Widyawati |
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Purpose : To report cases of challenging managements in cataract surgery in vitrectomized eye. This case reports complication resulting from inadequate scleral rigidity that also increase the difficulties. Our aims is to prevent complication and difficulty during cataract surgery that can raise from poorly dilated pupil and also anatomical changes that comes from vitreous exchange with liquid.
Methods : A case report.
Results : A 51-years-old with previous history of vitrectomy with indication of retinal detachment in high myopia which lead to thick hard nuclear opacity. Cataract surgery converted to manual nuclear extraction since the lens became unstabilized during surgery signing od zonular rupture, unfortunately the nucleus drop further to vitreus because the pupil became too small. The surgery continue after a few days with medication of topical sterorid and anti glaucoma therapy and finished with another vitrectomy and endofragmentation and anterior chamber iris clip IOL implanted. Second patient was a 64-years-old woman, with vitrectomized eye developed hard nuclear opacity of the lens. We performed phacoemulsification and had to convert again to manual nuclear extraction when we notice the sign of phacodenesis and decreasing pupil diameter. This time we use iris hook retractor before manually extracting the nucleus, the surgery went uneventfully and the three piece posterior chamber IOL implanted in the sulcus.
Conclusion : Adequate pupil dilatation should be achieved to start surgery in vitrectomized eyes, the loss of vitreous chusion and zonular weakness should be aware in managing the nucleus. The unusual anatomical change might rise the difficulty because the manipulation of nucleus in such a deep and soft scleral rigidity is though and risky.
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