97th DOG Annual Meeting 1999



O. Gareis, B. Nawaiseh, P. Wagner

Cataracts are a frequent complication after silicone oil infusion for the repair of retinal detachments. Therefore a combined procedure through a single scleral incision seems to be reasonable. We evaluated the results after phacoemulsification combined with transpupillary silicone oil removal und IOL-implantation.

Patients and methods: Thirty-four eyes of 34 consecutive patients were evaluated; 18 men, 16 women; mean age 65,3 years (23-85 yrs). The mean duration between vitrectomy and silicone oil removal was 9,1 months (2-18 months); in all cases 5000 centistoke silicone oil was used. A standard operation technique was performed with a 6 mm scleral tunnel incision, capsulorhexis, phacoemulsification, planned posterior capsulotomy for silicone oil removal via anterior chamber and tunnel incision with balanced salt solution. Afterwards a posterior chamber lens was implanted, mostly in the bag, seldom in the sulcus in case of a very large posterior capsulotomy.

Results: The visual acuity improved from 0,08 (LP-0,2) preoperatively to 0,2 (1/25-0,63) postoperatively. 4 of 34 eyes (=12%) developed a recurrent retinal detachment between 2 weeks und 27 months postoperatively. Also 4 of 34 eyes (=12%) showed a marked epiretinal gliosis. Vitreous hemorrhage, marked elevated intraocular pressure or visual acuity reducing subluxation or luxation of the IOL were not observed.

Conclusion: Phacoemulsifikation combined with transpupillary silicone oil removal and posterior chamber lens-implanation is a useful operation technique with good results. There are several advantages: only one access to the eye is necessary, no previous surgery in the area of present access and faster oil removal through the 6 mm incision than via pars plana.

University Eye Hospital, Prittwitzstraße 43, 89075 Ulm