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Altan A. Ozcan, MD
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Altan A. Ozcan, MD, demonstrates phacoemulsification and IOL implantation in a 54-year-old patient with a small cornea, and shallow anterior chamber with dense cataracts in both eyes. Extensive angle synechia was seen on gonioscopy, and he was diagnosed with nanophthalmos and secondary angle-closure glaucoma. Despite multiple peripheral iridectomies and trabs, the IOP remained elevated and uncontrolled on medication. A limited pars plana vitrectomy was performed to moderately reduce posterior pressure and deepen the anterior chamber. Then, phacoemulsification and a high-diopter, single-piece IOL implantation combined with goniosynechialysis were performed. In the follow up, visual acuity increased, anterior chamber deepened, and the IOP stabilized.
Posted: 9/20/2024
Altan A. Ozcan, MD
Altan A. Ozcan, MD, demonstrates phacoemulsification and IOL implantation in a 54-year-old patient with a small cornea, and shallow anterior chamber with dense cataracts in both eyes. Extensive angle synechia was seen on gonioscopy, and he was diagnosed with nanophthalmos and secondary angle-closure glaucoma. Despite multiple peripheral iridectomies and trabs, the IOP remained elevated and uncontrolled on medication. A limited pars plana vitrectomy was performed to moderately reduce posterior pressure and deepen the anterior chamber. Then, phacoemulsification and a high-diopter, single-piece IOL implantation combined with goniosynechialysis were performed. In the follow up, visual acuity increased, anterior chamber deepened, and the IOP stabilized.
Posted: 9/20/2024
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Antti Riikonen
11 months ago
One should really check the location of pars plana in these nanophtalmic eyes before entering, even going in 3mm back from the limbus you risk going through the retina in some of these patients. As a rule of thumb, shorter the axial length, more anterior should one enter. In some cases you should go in 2mm back from the limbus which may or may not be possible in a phakic eye. If you know you have a high risk of going through the retina, you can cryo the entry site intraoperatively.