Joshi Rajesh S
Department of Ophthalmology, Vasantrao Naik Govt. Medical College, Yavatmal, India.
Indian J Ophthalmol. 2016 Sep;64(9):659-662. doi: 10.4103/0301-4738.97072.
The purpose was to evaluate the results of modified sleeve in phacoemulsification of cataract in completely vitrectomised eyes, Materials and Methods: Twenty-five previously completely vitrectomized eyes of 23 patients having visually significant cataract were included. After through evaluation they underwent phaco-emulsification by phaco chop with a modified sleeve via temporal clear corneal incision. The modified sleeve was made by creating a small round port of approximate 1 × 1 mm size at the proximate end of the sleeve in line with the already existing ports. This port faced the posterior capsule while performing phacoemulsification. Patients were observed for any intraoperative complications.
The most common indication for pars plana vitrectomy in our study group was vitreous hemorrhage due to diabetic retinopathy [13 out of 25 eyes (52%)]. Intraoperative findings included miosis [seen in 3 (12%) eyes] and posterior capsular plaque [seen in 2(8%) eyes]. No other significant intraoperative complications (posterior capsular tear, dropped nucleus) were observed. Average effective phaco time was 33 sec. (±15.11).
Though cataract surgery in postvitrectomized eyes is a challenging situation, modified sleeve prevents anterior chamber fluctuation and avoids complications arising out of it, making the surgery safe.
评估改良套管在完全玻璃体切除术后白内障超声乳化手术中的效果。材料与方法：纳入23例患有视力显著下降白内障的患者的25只既往已完全玻璃体切除的眼睛。经过全面评估后，通过颞侧透明角膜切口，使用改良套管采用超声劈核技术进行超声乳化手术。改良套管是通过在套管近端与已有端口对齐处制作一个直径约1×1毫米的小圆孔制成。在进行超声乳化手术时，该孔朝向晶状体后囊。观察患者术中有无并发症。
在我们的研究组中，经平坦部玻璃体切除术最常见的指征是糖尿病性视网膜病变导致的玻璃体积血[25只眼中有13只（52%）]。术中发现包括瞳孔缩小[3只（12%）眼出现]和晶状体后囊斑块[2只（8%）眼出现]。未观察到其他显著的术中并发症（晶状体后囊撕裂、晶状体核掉落）。平均有效超声乳化时间为33秒（±15.11）。
尽管玻璃体切除术后的白内障手术具有挑战性，但改良套管可防止前房波动并避免由此引发的并发症，使手术更安全。
