Phacoemulsification in patients with nanophthalmos.
OBJECTIVE
To evaluate phacoemulsification surgery and its possible risks in patients with nanophthalmos.


METHODS
The surgical procedure, corneal diameter, keratometry, axial length, visual acuity, and intraoperative and postoperative complications were reviewed. Scleral thickness was determined by echography.


METHODS
5 patients, 8 eyes.


METHODS
The results of cataract surgery in nanophthalmic eyes were reviewed. Inclusion criteria was based on a clinical diagnosis of nanophthalmos and ocular surgery for cataract. Nanophthalmos was diagnosed according to a shorter than average axial length (usually less than 20.0 mm), typically a shallow anterior chamber, hyperopia, and scleral thickening greater than 1.5 mm. The procedure was planned as phacoemulsification, and foldable acrylic PCIOL implantation via a clear corneal tunnel.


RESULTS
The procedure was planned as phacoemulsification. Six eyes had cataract extraction with posterior chamber intraocular lens implantation by phacoemulsification. It was necessary to change the procedure to extracapsular cataract surgery in 2 cases because of uncontrolled shallowing of the anterior chamber. Postoperative trabeculectomy was needed in 1 eye, and Nd:YAG laser capsulotomy was performed on 4 eyes. No postoperative uveal effusion or infections were seen in any of the eyes. Complications included iritis with posterior synechia (n = 1), transient choroidal hemorrhage (n = 1), vitreous loss (n = 1), posterior capsule opacity (n = 4), and glaucoma (n = 1). In 1 case retinal detachment developed 3 weeks postoperatively. Prophylactic laser iridoplasty or iridotomy was not performed for surgery.


CONCLUSIONS
Although phacoemulsification seems to be relatively safe in nanophthalmic patients without performing any prophylactic surgical procedure, surgeons need to be attentive of the challenges of working through them when performing phacoemulsification in these high-risk eyes. However, with careful preoperative evaluation and planning, complications can be avoided.
epartment of Ophthalmology, Istanbul Bilim University, Istanbul, Turkey. erdalyuzbasioglu@mynet.com
Erdal
E
Yuzbasioglu
Ozgur
O
Artunay
Ahmet
A
Agachan
Harun
H
Bilen
D000368:Aged; D003315:Cornea / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008850:Microphthalmos / Q000601:surgery*; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D019591:Pseudophakia / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012590:Sclera / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology