Intravitreal Phacoemulsification Through Corneal Incision for Management of Posteriorly Dislocated Lens Material After Complicated Cataract Surgery: A New Surgical Technique.

Intravitreal Phacoemulsification Through Corneal Incision for Management of Posteriorly Dislocated Lens Material After Complicated Cataract Surgery: A New Surgical Technique Phacoemulsification is the most frequently performed ophthalmologic surgery, and very satisfactory outcomes are usually achieved. However, final outcome may be affected by surgical complications, being the posterior capsular rupture the most commonly reported. It occurs in 0.45% to 5.2% of cataract surgeries1 and could be associated with lens material dislocation into the vitreous cavity in 0.3% to 1.5% of cases.2–4 Presence of lens fragments in the vitreous cavity, especially its nuclear portion, leads to corneal edema, uveitis, cystoid macular edema, and glaucoma.2,3,5 Therefore, timely and proper removal of lens material from the vitreous cavity by a retina specialist is required to avoid these complications.6,7 Traditionally, retained lens material removal is achieved by performing three-port pars plana vitrectomy, followed by fragmentation and extraction of the material using a fragmatome.2 The latter is a 20-gauge instrument; therefore, it requires either a port of such caliber or the expansion of one of the ports previously created, as in the case of a smaller gauge vitrectomy. In addition, it uses longitudinal ultrasound, which generates a repulsive effect on the lens fragments, which causes mechanical trauma to the retina and prolonged duration of surgery.3–5 The ideal technique for retained lens fragments would be one that is safe and efficient, regardless of lens hardness. In addition, it should maintain the benefits of small-gauge vitrectomy leading to little inflammation, and few complications. Therefore, in this study, we describe a new surgical technique for posteriorly dislocated lens material removal and its outcomes, which strongly suggest that our technique is closely approximating to an ideal one.