[Phacoemulsification cataract surgery in vitrectomized eyes]. / Facoemulsificación en ojos post-vitrectomía pars plana.

OBJECTIVE: This study focuses on determining the intra- and post-operative complications stemming from technical difficulties, anatomical aspects, intraoperatory management and visual outcome of post-vitrectomized patients that undergo phacoemulsification. METHOD: In this prospective, longitudinal, observational and descriptive study phacoemulsification was performed in 25 post-vitrectomized eyes that required cataract surgery. Pre-surgical variables: sex, age, affected eye, visual accuity, underlying vitreoretinal disease, anterior segment morphological findings such as: cataract density and pupil alterations. Intrasurgical variables: characteristic of anterior chamber and pupil, phacoemulsification technique and time and the presence of complications. Post-surgical variables were also registered: visual capacity and the presence of complications. Minimum six-month follow-up period. RESULTS: The average interval between pars plana vitrectomy and phacoemulsification was 18.5 months. Silicone oil was the most frequent tamponade used in our serie (44%). Biomicroscopical findings were miosis 28% and posterior synechies 24%. The average interval of phaco time was 2.26 minutes. The intraoperative findings were fluctuations in the anterior chamber depth (24%) and anterior capsular tears (12%). The postoperative complications most frequently seen were posterior capsular plaque (28%) and corneal edema (16%). CONCLUSIONS: Phacoemulsification is a safe and effective technique in eyes after pars plana vitrectomy that require cataract surgery. The surgeon must be aware of the morphological and anatomical findings of these eyes. Visual rehabilitation will generally be determined by the presence of an underlying vitreo-retinal pathology.

Facoemulsificación en ojos post-vitrectomía pars plana / Phacoemulsification cataract surgery in vitrectomized eyes

Objetivo: Determinar las complicaciones intra y postoperatorias en ojos de pacientes post-vitrectomizados que ameritan cirugía de catarata con técnica de facoemulsificación. Método: Estudio prospectivo, longitudinal observacional y descriptivo en 25 ojos de 25 pacientes, previa vitrectomía pars plana que requerían cirugía de catarata. Variables prequirúrguicas: edad, sexo, ojo afectado, capacidad visual, patología vitreorretiniana, características morfológicas del segmento anterior tales como grado de opacidad del cristalino, características de la cámara anterior y de la pupila. Variables intraoperatorias: técnica, tiempo de facoemulsificación y complicaciones intraoperatorias. Variables post-operatorias: Complicaciones y capacidad visual. Seguimiento no menor de 6 meses. Resultados: El tiempo promedio entre la vitrectomía pars plana y la facoemulsificación fue de 18,5 meses. La silicona fue el material de tamponamiento utilizado con mayor frecuencia 44%. Hallazgos biomicroscópicos: miosis 28% y sinequias posteriores 24%. El tiempo promedio de facoemulsificación: 2,26 minutos. Complicaciones intraoperatorias: cámara anterior inestable 24% y el desgarro de la capsulorrexis anterior 12%. La complicación post-operatoria más frecuente fue la placa subcapsular posterior 28% y el edema corneal 16%. Conclusiones: La facoemulsificación en ojos con vitrectomía pars plana previa que ameriten cirugía de catarata, es una técnica bastante segura y efectiva. El cirujano debe familiarizarse con los hallazgos y modificaciones anatómicas que sufren estos ojos. La rehabilitación visual por lo general va a estar limitada por la patología vitreo-retiniana de base(AU)

Objective: This study focuses on determining the intra- and post-operative complications stemming from technical difficulties, anatomical aspects, intraoperatory management and visual outcome of post-vitrectomized patients that undergo phacoemulsification. Method: In this prospective, longitudinal, observational and descriptive study phacoemulsification was performed in 25 post-vitrectomized eyes that required cataract surgery. Pre-surgical variables: sex, age, affected eye, visual accuity, underlying vitreoretinal disease, anterior segment morphological findings such as: cataract density and pupil alterations. Intrasurgical variables: characteristic of anterior chamber and pupil, phacoemulsification technique and time and the presence of complications. Post-surgical variables were also registered: visual capacity and the presence of complications. Minimum six-month follow-up period. Results: The average interval between pars plana vitrectomy and phacoemulsification was 18.5 months. Silicone oil was the most frequent tamponade used in our serie (44%). Biomicroscopical findings were miosis 28% and posterior synechies 24%. The average interval of phaco time was 2.26 minutes. The intraoperative findings were fluctuations in the anterior chamber depth (24%) and anterior capsular tears (12%). The postoperative complications most frequently seen were posterior capsular plaque (28%) and corneal edema (16%). Conclusions: Phacoemulsification is a safe and effective technique in eyes after pars plana vitrectomy that require cataract surgery. The surgeon must be aware of the morphological and anatomical findings of these eyes. Visual rehabilitation will generally be determined by the presence of an underlying vitreo-retinal pathology(AU)

[Choroidal melanoma treated with 810 nm diode laser and indocyanine green. A case report]. / Reporte de caso. Melanoma de coroides fotocoagulado con láser de diodo 810 nm coadyuvado con verde de indocianina.

CASE REPORT: A 35 year-old female with a pigmented choroidal tumor in the inferotemporal quadrant, of 3.31 x 7.64 x 5.46 mm. The patient received an intravenous injection of 25 mg of indocyanine green previous to photocoagulation of the lesion with an 810 nm diode laser. After one year follow-up the tumor showed involution demonstrated by clinical and ultrasonographic evaluation. DISCUSSION: Indocyanine green allows maximal absortion of light energy delivered by diode laser, enhancing its action by making the deepest tissues vulnerable to photocoagulation and reducing time of exposure and number of sessions.

Reporte de caso. Melanoma de coroides fotocoagulado con láser de diodo 810 nm coadyuvado con verde de indocianina / Choroidal melanoma treated with 810 nm diode laser and indocyanine green. A case report

Caso clínico: Paciente femenino de 35 años de edad con presencia de tumoración coroidea pigmentada en cuadrante inferotemporal, de 3,31x7,64 x 5,46 mm. La lesión se fotocoaguló con láser de diodo de 810 nm previa inyección intravenosa de 25 mg de verde de indocianina.Tras un año de seguimiento el tumor mostró involución demostrada por clínica y ultrasonido.Discusión: El verde de indocianina permite máxima absorción de la energía luminosa suministrada por el láser de diodo, potenciando su acción al hacer a los tejidos más profundos vulnerables a la fotocoagulación, reduciendo el tiempo de exposición y número de sesiones (AU)

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