Endoscopy-assisted pars plana lensectomy for brunescent cataracts in eyes with microcornea with microphthalmos

ABSTRACT

Purpose

Conventional cataract surgeries can be a challenge in eyes with microcorneas due to difficult manipulation in a crowded anterior chamber (AC) and can lead to a high occurrence of corneal edema and an increased rate of complications. Similarly, in cases of dense brunescent cataracts even a lensectomy through posterior approach may prove to be difficult because of inadequate visualization. An endoscopyassisted pars plana lensectomy can help in obviating these difficulties. This study aims to describe the surgical technique of endoscopy-assisted pars plana lensectomy in eyes with brunescent cataract, microcornea, and microphthalmos.

Methods

Retrospective review of two cases where endoscopy-assisted pars plana vitrectomy and lensectomy was performed for patients with dense cataract and microcornea and microphthalmos.

Result

Complete clearance of the cataract was achieved without having to resort to a sclerocorneal incision. Postoperatively the cornea was clear and there was no postoperative corneal edema.

Conclusion

Endoscopy-assisted pars plana lensectomy can help in overcoming the challenges of conventional anterior and posterior approaches of cataract extraction in cases of microcornea with reduced intraoperative and postoperative complications.

KEYWORDS:

• Cataract
• endoscopy
• microcornea
• microphthalmos
• pars plana lensectomy

Disclosure statement

All authors certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Supplemental Digital Content

Surgical Video: Endoscopy-assisted Lensectomy in eyes with Microcorneas (MP4 file)

Summary statement

Cataract surgeries in eyes with microcorneas and microphthalmos are challenging due to reduced anterior chamber depth, small non-dilating pupil, increased lens thickness, dense cataract and lax zonules. An endoscopy-assisted pars plana approach can overcome these challenges and can help achieve better outcomes in such cases