Posterior lens capsule delineation during pars plana vitrectomy

Introduction A known complication of cataract surgery, during combined phacoemulsification and vitrectomy, is rupture of the posterior capsule, which occurs at a rate of 0.82-2.1%. Objective The aim of the study was to optimize the visualization of the posterior lens capsule during pars plana vitrectomy to prevent its injury during the procedure. Design This investigation was designed as a case-control study. Settings Patients visiting the Kasr Al-Aini Cairo University Hospitals Outpatient Clinic of Ophthalmology during the period from January 2012 to June 2013 were selected for the study. Participants and methods This study was conducted on two groups of patients. In group I (49 eyes), a few small air bubbles were allowed to pass through the infusion cannula and into the eye where they adhered to the posterior lens capsule, whereas in group II (control, 52 eyes) phacovitrectomy was carried out without air bubbles. Primary outcome measure The integrity of the posterior lens capsule during vitrectomy was considered the primary outcome measure. Results In group I comprising 49 (100%) vitrectomized eyes, the posterior lens capsule was perfectly visualized and avoided during detachment of the anterior hyaloid face, during total vitrectomy and during vitreous base shaving. In group II, there was one eye with posterior capsule rupture and intraocular lens drop (1.9%). Conclusion and relevance Small air bubbles help perfect delineation of the posterior lens capsule during vitrectomy, avoiding its injury.