When the capsule breaks during cataract surgery and the vitreous prolapses into the anterior segment, it is important to clear this prior to insertion of the IOL. The traditional teaching is to make two limbal incisions and then perform a small-gauge bimanual anterior vitrectomy. But this requires that we keep pulling vitreous strands through the posterior capsule defect.
Another great option is presented here by Professor Ahmed Assaf from Egypt who is showing us the pars plana anterior vitrectomy technique. I have been teaching this technique to my residents for many years and it produces excellent results. By having the vitrectomy probe through pars plana, we are able to draw any prolapsed vitreous back into the vitreous cavity where it belongs. This approach also puts less traction and stress on the vitreous and that is a bonus for the safety of the retina.
Click below to learn how to perform a pars plana anterior vitrectomy:
Excellent video Dr. Devgan, as always! And congratulations professor Assaf
Muy question is: is it advisable yo use pars plana trocars? Do we have to fear vitreous getting caught un the pars plana incission ir we don’t?
Either way is good. Often easier to do without trocars. In both cases the surgeon must check for entry site breaks.
Thank you for your answer professor Devgan!
Excellent management from an excellent surgeon
Yes. I agree. Good teaching points