Cataract development after vitrectomy is common. The type of cataract is generally nuclear. Despite the fact that the nucleus itself may not be particularly challenging, the rate of complications in vitrectomized eyes is reported to be significantly higher than normal.
Consideration must be given not only to the actual performance of the surgery but also to its planning, from biometry and decisions about incision configuration and IOL design to the best type of anaesthesia to use.
PREOPERATIVE WORKUP
Certain decisions must be made before surgery, generally related to biometry and IOL choice. If silicone oil was used, this can influence ultrasound biometry results, as sound travels at a different speed in oil than in the vitreous gel; optical biometry should overcome this issue.
IMPORTANT
A careful history of the reasons for vitrectomy and what took place at surgery is essential prior to the start of cataract surgery.
When considering IOL choice in these eyes, remember that a three-piece lens with stiff haptics is a good option in very myopic eyes and a capsular tension ring can be helpful in eyes in which a one-piece IOL was chosen.
The defining issue in removing a cataract from a previously vitrectomized eye is the potential for lens-iris– diaphragm retropulsion syndrome.
#posteriorpupillaryblock
#lensirisdiaphrgmretopulsion syndrome
#LIDRS
CONCLUSION
With a little care and thought about biometry, IOLs, anaesthesia, incisions, and capsulotomy, combined with manoeuvres to avoid LIDRS, cataract surgery in post vitrectomy eyes can conclude with satisfactory outcomes.
