Aim
The aim of this study was to evaluate the outcome of pars-plana vitreous aspiration
during combined trabeculectomy, phacoemulsification, and intraocular lens (IOL)
implantation in eyes with shallow anterior chamber (AC) to prevent its associated
complications.
Patients and methods
Fifty-four eyes of 46 patients were included in this study. All eyes were indicated for
combined trabeculectomy, phacoemulsification and IOL implantation. All eyes had
very shallow AC and injection of a viscoelastic substance through AC paracentesis
failed to deepen the AC. Vitreous aspiration was performed with a 27G needle on a
3 ml syringe over the pars plana 3.5mm posterior to the limbus in the
superotemporal quadrant. The cases were followed up for 12 months. The main
outcome measures were the volume of aspirated vitreous, and intraoperative and
postoperative complications.
Results
Intraoperative deepening of the AC occurred in all cases after vitreous aspiration.
Aspirated vitreous volume varied from 0.3 to 0.7 ml (average 0.47 ml). There was no
evidence of positive vitreous pressure during surgery in any case. No intraoperative
complications occurred in all cases. Postoperative complications were detected in
the form of shallow AC with hypotony in 5.5% of the cases (3 out of 54 cases) and
shallow AC with high intraocular pressure was reported in 3.7% of the cases (2 out
of 54 cases). All cases were managed without the need for a second surgery.
Complications related to vitreous aspiration like vitreous hemorrhage, retinal tear,
or detachment were not observed in any case.
Conclusion
Pars-plana vitreous aspiration is a safe procedure to prevent intraoperative shallow
AC and its associated complications during combined trabeculectomy,
phacoemulsification, and IOL implantation. |
