Bimanual microphacoemulsification and Acri. Smart intraocular lens implantation combined with vitreoretinal surgery.
OBJECTIVE
To assess the efficacy and safety of bimanual microphacoemulsification combined with vitrectomy in eyes with clinically evident cataract and vitreoretinal pathology.


METHODS
Institute of Ophthalmology of the University of Modena and Reggio Emilia, Modena, Italy.


METHODS
This prospective case series comprised 19 consecutive patients with clinically significant cataract who were scheduled for vitrectomy. Bimanual microphacoemulsification was performed, and an Acri. Smart 46 S hydrophobic acrylic intraocular lens (IOL) with a 6.0 mm optic (Acri.Tec, Inc.) was implanted in the capsular bag. Immediately after, standard 3-port vitrectomy was performed.


RESULTS
The prevailing vitreoretinal pathology was retinal detachment, with 1 case of macular pucker and 1 case of macular hole. In all cases, the IOL was implanted in the capsular bag. There were no intraoperative complications during the cataract surgery or vitrectomy. Follow-up 1, 15, 30, 90, and 180 days after surgery showed significant visual recovery in all cases. The mean endothelial loss was 10.05%+/-2.01% (SD). In 3 cases that had tamponade with heavy silicone oil, progressive posterior capsule opacification occurred 6 months after surgery.


CONCLUSIONS
Bimanual microphacoemulsification combined with vitrectomy was effective and safe. The microincisions and 19-gauge instruments provided excellent chamber resistance that simplified surgical maneuvers in eyes that might have a distorted fundus reflection and increased zonular laxity. The Acri. Smart 46 S IOL, which can be injected through a 2.0 mm incision, provided good fundus visibility during vitrectomy and good maneuverability up to the extreme periphery without resulting in glare or distracting reflections for the surgeon.
Cavallini
Gian Maria
GM
Università degli Studi di Modena e Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Struttura Complessa di Oftalmologia, Modena, Italy. cavallini.gianmaria@unimore.it
Pupino
Alessandro
A
Masini
Cristina
C
Campi
Luca
L
Pelloni
Simone
S
D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D014792:Visual Acuity; D014821:Vitrectomy
D000180:Acrylic Resins