[Secondary implantation of posterior chamber intraocular lenses in reconstructive surgery of the anterior segment and infusion of fluid through the pars plana].
BACKGROUND
A deep anterior chamber can be perioperative maintained by irrigation solution or by viscoelastic material. By longlasting reconstructive procedures after penetrating injuries we use an infusion through a pars plana cannula.


METHODS
Between January 1994 and February 1995 five patients (aged 17-28 years) underwent secondary IOL implantation after penetrating eye injury with traumatic cataract. The reconstructive procedure was performed 6-11 years after the injury and linear cataract extraction. In all eyes corneal scars, iris anterior and posterior synechias, vitreous prolaps, and fibrotic posterior capsule remnants were present. The preoperative visual acuity ranged from 0.05-1.0. A pars plana infusion cannula was positioned 3 mm posterior to the limbus. In one eye with glaucoma a trabeculectomy and in two eyes with a greater defect of the posterior capsule, a lamellar scleral flap for transscleral suturing of one IOL haptic were performed. Then the prolapsed vitreous between cornea and infusion cannula was removed using the vitreous cutter. Iris synechiae were blunt or sharp dissected, the cortical masses were aspirated, the fibrotic or calcificated lens remnants were ectomised and an IOL was implanted into the ciliary sulcus. Two haptics were transsclerally fixated. The follow-up period ranged from 4-18 months.


RESULTS
The surgery duration ranged between 45-90 minutes. No perioperative complications were recorded. On the fourth postoperative day bleeding into the anterior chamber and vitreous in one patient with transsclerally fixated haptic was observed. The blood reabsorbed spontaneously within a week. No complications from the infusion cannula could be observed. The postoperative visual acuity is 0.1-1.0.


CONCLUSIONS
The permanent pars plana infusion maintains a stabile anterior chamber depths and intraocular pressure. The deep anterior chamber allows long-lasting surgical manoevers with less risk of corneal endothelium damage.
Strmen
P
P
Klinika oftalmológie LF UK, Bratislava, CSc.
D000293:Adolescent; D000328:Adult; D000867:Anterior Chamber / Q000601:surgery*; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D065306:Corneal Injuries; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage*; D019654:Lens Implantation, Intraocular / Q000379:methods*; D008297:Male; D012086:Reoperation; D000077325:Ringer's Lactate; D007507:Therapeutic Irrigation / Q000379:methods
D007552:Isotonic Solutions; D000077325:Ringer's Lactate
Sekundárna implantácia zadnokomorovej vnútroocnej sosovky pri rekonstrukcných operáciách predného segmentu s prívodom náhradného roztoku cez pars plana.