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Microincision phacoemulsification combined with sutureless transpupillary passive silicone oil removal
Mithun Thulasidas1, Hemlata Gupta1, Mahipal S Sachdev1
1Cataract and Refractive Surgery Services, Centre for Sight, Safdarjung Enclave, New Delhi, India.
Purpose:
To evaluate the outcomes of combined microincision phacoemulsification with sutureless transpupillary silicone oil (SO) removal using an irrigation probe of bimanual irrigation/aspiration.
Methods:
We conducted a single-center retrospective study, including patients who had undergone phacoemulsification with transpupillary removal of SO, which had been used for intraocular tamponade after a previous pars plana vitrectomy. Outcome measures were corrected distance visual acuity (CDVA), refractive error, intraocular pressure (IOP), and endothelial cell count (ECC) evaluated preoperatively and postoperatively at 3-month follow-up. Any intraoperative or postoperative complications, duration of surgery, and final retinal status at 3 months were also noted.
Results:
Seventy-four eyes (74 patients) were analyzed. The mean interval between SO placement and cataract surgery was 4.73 months (standard deviation [SD]: 1.02). CDVA improved in 66 (89.2%) eyes and remained the same in 8 (10.8%) eyes (P < 0.001). The mean postoperative spherical equivalent was -0.96D (SD: 0.75) at 3 months (P < 0.001). There was a significant drop in IOP from 15.08 mmHg (SD: 2.67) preoperatively to 11.64 mmHg (SD: 2.02) postoperatively (P < 0.001). The average ECC loss was only 5.7% at 3 months postoperatively. The mean surgical duration was 17.20 min (SD: 7.02). One patient had retinal redetachment and required resurgery. At 3 months, the retina was attached in all patients.
Conclusion:
Combined microincision phacoemulsification with transpupillary passive SO removal using irrigation probe of bimanual irrigation/aspiration is a safe, effective, and less invasive technique that offers the main advantage of reduced surgical trauma, and should be reserved for patients with a stable retina, not requiring additional surgical intervention.
Insights
This study shows that combining cataract surgery with silicone oil removal is safe and effective. The technique improves vision and reduces intraocular pressure with minimal trauma.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Retinal Surgery
Background:
- Silicone oil (SO) is used for intraocular tamponade after pars plana vitrectomy.
- Cataract development is a common complication after SO tamponade.
- SO removal is often necessary before or during cataract surgery.
Purpose of the Study:
- To evaluate the outcomes of combined microincision cataract surgery (phacoemulsification) with sutureless transpupillary silicone oil (SO) removal.
- To assess the safety and efficacy of this combined procedure.
Main Methods:
- A retrospective, single-center study analyzed 74 eyes.
- Patients underwent phacoemulsification with transpupillary SO removal using bimanual irrigation/aspiration.
- Outcomes included corrected distance visual acuity (CDVA), refractive error, intraocular pressure (IOP), and endothelial cell count (ECC) at 3-month follow-up.
Main Results:
- CDVA improved in 89.2% of eyes (P < 0.001).
- Postoperative spherical equivalent was -0.96D (P < 0.001), and IOP significantly decreased (P < 0.001).
- Average endothelial cell loss was 5.7%, with a mean surgical duration of 17.20 minutes.
Conclusions:
- Combined microincision phacoemulsification with transpupillary SO removal is a safe, effective, and less invasive technique.
- The procedure offers reduced surgical trauma.
- It is recommended for patients with a stable retina not requiring further surgical intervention.
