CAPSULECTOMY AND PARTIAL VITRECTOMY FOR TREATMENT OF PROGRESSIVE POSTERIOR CAPSULE OPACIFICATION
C. Niederstadt, R.J. Keuch, H. Bleckmann
In most cases a pseudophacic posterior capsule opacification can be treated successfully with Nd: YAG-laser capsulotomy. In case of progressive opacification of the posterior capsule the laser treatment might fail even when high laser energy, by inreasing the risc of lens demage and/or retinal detachement, is used. In those cases the surgical capsulectomy should be discussed as an alternative procedure to the Nd: YAG-laser capsulotomy. In this study we reviewed selected cases that underwent surgical capsulectomy and partial vitrectomy.
Methods: We reviewed a number of 10 pseudophacic patients with pseudophacia and functional visual loss caused by progressive opacification of the posterior capsule who underwent surgical capsulectomy with partial vitrectomy between 1997 and 1998. Surgical approach was done via pars plana, followed by partial vitrectomy including anterior vitreous membrane, excision and mobilisation of the posterior capsule eventually with a Sato-knife, final vitrectomy and posterior lens polishing, closure of the sclerotomy. Follow up was performed up to 8 months postoperative. Special interest was given to the change of visual acuity (VA), intraocular pressure (IOP) and postoperative complications.
Preliminary Results: Median follow up 4.8 months (2-8 m.); Improved VA in all cases; median VA preoperative 0.18 (V 0.05-0.32), median VA postoperative 0.67 (V 0.3-1.0); median IOP preoperative 18.6 mmHg (15- 24 mmHg), median IOP postoperative 17.7 mmHg (12-22 mmHg); only small improvement of postoperative VA in 3 eyes (30 %) with AMD; slight IOL-decentration in 2 eyes (20 %); transient vitreous haemorrhage in 2 eyes (20 %); no further complications.
Summary: Capsulectomy and partial vitrectomy in selected cases with progressive posterior capsule opacification proved to be an effective and save method to improve visual function.
Schlosspark-Klinik, Augenabteilung, Heubnerweg 2, D-14059 Berlin