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Related Experiment Videos

Capsular phimosis following phacotrabeculectomy.

Abdel Hakim Taguri1, Hilary Devlin

  • 1Princess Alexandra Eye Pavilion, Edinburgh, Scotland.

Ophthalmic Surgery, Lasers & Imaging : the Official Journal of the International Society for Imaging in the Eye
|June 17, 2005
PubMed
Summary

Severe capsular phimosis can occur after augmented phacotrabeculectomy, especially with intense inflammation. This complication may be prevented by considering separate surgeries or modifying the technique to ensure a larger capsulorhexis.

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Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Glaucoma Surgery

Background:

  • Augmented phacotrabeculectomy combines cataract extraction with glaucoma surgery.
  • Postoperative fibrinous uveitis is a potential complication, characterized by significant intraocular inflammation.
  • Capsular phimosis, or shrinkage of the capsular bag, can impede visual outcomes.

Observation:

  • Three cases of severe capsular phimosis following augmented phacotrabeculectomy with intense postoperative fibrinous uveitis are presented.
  • The inflammation may stem from the combined procedure, pupil stretching, and compromised blood-aqueous barrier.
  • Small capsulorhexis size due to pupil stretching was noted in these cases.

Findings:

  • Fibrinous uveitis and small capsulorhexis are identified as potential risk factors for severe capsular phimosis.

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  • These risks are present even without pre-existing zonular weakness or preoperative uveitis.
  • The complication can jeopardize the success of otherwise effective glaucoma and cataract surgery.

    • Implications:

    • For high-risk patients, performing cataract extraction and trabeculectomy as separate procedures may be advisable.
    • Alternatively, surgeons could employ a larger capsulorhexis or radial relieving incisions during phacotrabeculectomy.
    • These modifications aim to mitigate the risk of capsular phimosis and preserve surgical outcomes.