In part 3 of our series of videos covering the steps for PVR-associated RD repair, we switch our attention to the anterior chamber. In phakic patients undergoing re-operation, the presence of a cataract may obscure the surgical view. As in any surgical case, good visualization is one of the most important factors affecting the success of the surgery. Lens and capsule removal in this case can also remove the framework for anterior PVR formation, thereby decreasing the patient’s risk for postoperative hypotony.
Lens removal can be performed either anteriorly, with phacoemulsification, or posteriorly with the vitreous cutter or phacofragmatome. In this video we discuss some of the pros and cons of these approaches and some surgical considerations when performing phacoemulsification on a vitrectomized eye. Finally we review some options for capsule removal, which was more difficult than expected in this case.
