Cataract surgery and transpupillary silicone oil removal through a single scleral tunnel incision under topical anesthesia; Sutureless surgery

Abstract

The author evaluated the results of combined cataract extraction and transpupillary silicone oil removal through a single scleral tunnel incision, in eyes that had undergone pars plana vitrectomy with silicone oil tamponade. Twenty-four of the 46 eyes were operated on under topical anesthesia with Blumenthal mode mini-nucleus manual extracapsular cataract extraction technique (mini- nuc ECCE), and silicone oil was removed passively through planned posterior capsulorhexis via the scleral tunnel, followed by endocapsular intraocular lens (IOL) implantation. The operation was completed without any suturing. The remaining 22 eyes were similarly operated on with the same cataract extraction technique, but in these cases silicone oil was classically aspirated actively through pars plana sclerotomies. Results were evaluated by visual acuity measurement, duration of operation, and complications. The transpupillary silicone oil removal group had significantly less vitreous hemorrhage (0-31.8%) and posterior capsule opacification (0-36.4%). Also, the mean duration of the operation was significantly shorter in this group. There was no significant difference between the two groups with regard to postoperative recurrence of retinal detachment (12.5-18.1%) and visual acuity outcome. The combination of mini-nuc ECCE with transpupillary silicone oil removal compares favorably with the combination of silicone oil aspiration through pars plana sclerotomies. This combined technique allows the surgeon to perform the operation under opical anesthesia and no sutures are required. The intervention period is shorter and no posterior capsule opacification or vitreous hemorrhage develops.