Anterior vitreous detachment: risk factor for intraoperative complications during phacoemulsification. 2020

Natalia S Anisimova, and Lisa B Arbisser, and Natalya F Shilova, and Maria A Melnik, and Alexandra V Belodedova, and Boris Knyazer, and Boris E Malyugin
From the S. Fyodorov Eye Microsurgery Complex State Institution (Anisimova, Belodedova, Shilova, Malyugin), Moscow, A.I. Yevdokimov Moscow State University of Medicine and Dentistry (Anisimova, Malyugin), Russia; John A. Moran Eye Center (Arbisser), University of Utah , USA; and Ophthalmology Department, Soroka University Medical Center (Knyazer), Be'er-Sheva, Israel.

To confirm the presence of incomplete vitreolenticular adhesion via microscope-integrated intraoperative optical coherence tomography (iOCT) during cataract surgery and via diagnostic spectral-domain OCT (SD-OCT) postoperatively. S. Fyodorov Eye Microsurgery Complex State Institution, Moscow, Russia. Prospective noninterventional single-center study. Clinical characteristics and surgical videos of 27 patients (28 eyes) who had cataract surgery were documented. Real-time iOCT integrated into the surgical microscope was directed to view the retrolenticular anatomy at the end of the surgery. Postoperatively, SD-OCT was also performed. This study comprised 28 eyes of 27 patients. Berger space was identified in 21 cases (75%) intraoperatively via iOCT and in 23 cases (82%) postoperatively via stationary OCT. Depth dimensions varied from 33.5 ± 87.0 μm to 383.1 ± 226.3 μm. Hyperreflective dots and particles of different shapes and sizes were documented within Berger space in 16 cases (57%) intraoperatively and in 9 cases (32%) postoperatively. Capsular rupture occurred in 1 case due to excessive posterior capsular movement anteriorly. The posterior capsular rupture was converted into a posterior capsulorhexis, leaving the anterior hyaloid membrane intact. iOCT confirmed the penetration of crystalline lens microfragments, cellular material, or medical suspension (triamcinolone) into the space between the posterior lens capsule and the anterior hyaloid membrane. This occurs due to discontinuity of both lenticular zonules and Wieger ligament attachment. A Wieger ligament rupture can also allow excessive Berger space hydration during phacoemulsification leading to anterior displacement of the posterior lens capsule increasing the risk of instrument touch and posterior capsule rupture.

UI MeSH Term Description Entries
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000869 Anterior Eye Segment The front third of the eyeball that includes the structures between the front surface of the cornea and the front of the VITREOUS BODY. Anterior Eye Segments,Eye Segment, Anterior,Eye Segments, Anterior,Segment, Anterior Eye,Segments, Anterior Eye
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor
D014741 Video Recording The storing or preserving of video signals to be played back later via a transmitter or receiver. Audiovisual Recording,Videorecording,Audiovisual Recordings,Recording, Audiovisual,Recording, Video,Recordings, Audiovisual,Recordings, Video,Video Recordings,Videorecordings
D055675 Viscosupplements Viscoelastic solutions that are injected into JOINTS in order to alleviate symptoms of joint-related disorders such as OSTEOARTHRITIS. Visco Supplements,Viscosupplement,Supplements, Visco

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