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Triple procedure may help improve retinal reattachment outcomes
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A combined procedure involving cataract removal, IOL implantation and scleral buckling can be effective for treating retinal breaks, sparing patients repeated surgery or delays in retinal reattachment, a Japanese study indicates.
Tseng-Chiang Tsai, MD, and Wen-Chuan Wu, MD, studied six patients with dense cataracts accompanied by retinal detachment. All patients underwent the triple procedure. Phacoemulsification was performed for cataract removal, followed by localization of the retinal break using a binocular indirect ophthalmoscope. A foldable posterior chamber IOL with a 5.5-mm optic was then implanted. The authors noted that the viscoelastic was kept in the eye during lens implantation and was removed after scleral buckling surgery was performed for the retinal reattachment.
In all cases, a clear view of the fundus was obtained, and retinal breaks were identified in five patients. The retina was successfully reattached in all six cases, five of whom also showed an improvement in visual acuity.
In this procedure, the retinal break was localized while the eye was in an aphakic state to avoid the effects of multiple optics, namely between the IOL and non-IOL lenses.
Keeping the viscoelastic in the eye during IOL implantation also helped to maintain lens centration and was removed after retinal reattachment to avoid possible postoperative elevations in IOP, the authors wrote. None of the patients experienced any ocular hypertension, they added.
The study was published in the January/February issue of Ophthalmic Surgery, Lasers & Imaging.