Alterations of the anterior lens capsule in vitrectomized eyes with silicone oil tamponade

All eyes underwent core vitrectomy followed by removal of the posterior hyaloid membrane and vitreous traction. Retinal photocoagulation was performed in selected eyes via a laser. After vitrectomy, the fluid in the vitreous cavity was exchanged with 1,000-centistoke silicone oil in all cases. All injections were performed with the same silicone oil (PDMS(Registered Trademark)). Patients who had on clinical examination a posterior subcapsular cataract formation secondary to intravitreal silicone oil injection were eligible for this study. There were also 10 patients with posterior subcapsular cataracts called the control group. All eyes were operated on for silicone oil removal and cataract extraction by phacoemulsification with intraocular lens implantation in the same operation. The mean silicone oil removing time was 4.4+/-1.1 months (3-6 months). Surgeries were performed by one surgeon under local anesthesia by retrobulbar injection. Upper and lower temporal conjunctival incision were performed. Lower temporal sclerotomy for the infusion cannula was carried out and the infusion cannula was inserted. The anterior chamber was irrigated with balanced salt solution to remove possible small silicone bubbles. The anterior chamber was filled with sodium hyaluronate 1.4 % (Healon GV(Registered Trademark)). An anterior capsulorhexis with a diameter of approximately 4.0 to 5.0 mm was created in the central region of the anterior lens capsule. Anterior capsule was removed and examined with the electron microscopy. Phacoemulsification was accomplished through clear corneal incision. An acrylic intraocular lens was implanted in the bag. Upper temporal sclerotomy for removal of silicone oil was performed. The infusion canula was then opened, and silicone oil was aspirated actively using a syringe. A central posterior capsulotomy was performed in required cases by vitrectomy probe. A fundus was evaluated with the wide field system with indentation of the periphery to ensure that the retina was attached and the silicone oil completely removed. Subsequently fluid-air exchange was performed. Average surgery time is 1.5 hours. This is a parallel case control study