Management of Nucleus and IOL Drop

Area of Science:

• Ophthalmology
• Surgical Techniques
• Retina and Vitreous Surgery

Background:

• Complications of phacoemulsification include lenticular nucleus drop and posterior intraocular lens (IOL) dislocation.
• A total of 77 cases (36 nuclear drop, 43 IOL dislocation) were managed, including two pediatric cases.
• Previous management often involved perfluorocarbon liquid (PFCL), but this study explores an alternative.

Purpose of the Study:

• To evaluate a modified vitrectomy procedure for managing dropped nuclei and dislocated IOLs.
• To assess the visual outcomes of this technique without using PFCL.
• To establish the efficacy of prompt surgical intervention for these specific complications.

Main Methods:

• A modified vitrectomy approach was employed using inferotemporal pars plana and limbal incisions.
• Nucleus drop cases involved impaling the nucleus with a micro vitreo retinal blade for anterior chamber delivery.
• IOL dislocation cases utilized intra-vitreal forceps for retrieval.

Main Results:

• Fifty-seven out of 77 adult eyes (74%) achieved a visual recovery of 6/18 or better.
• The modified vitrectomy technique demonstrated successful management of both nuclear fragments and dislocated IOLs.
• No mention of complications or specific visual acuity in pediatric cases.

Conclusions:

• Prompt surgical management of nuclear drop or posterior IOL dislocation leads to favorable outcomes.
• The modified vitrectomy technique offers an effective alternative to PFCL for these challenging situations.
• This approach can significantly improve visual prognosis following complex cataract surgery complications.