Managing Challenges of Phacoemulsification in Vitrectomized Eyes: A New Technique

AIM: This study aimed to describe a novel approach to manage the challenges of phacoemulsification in vitrectomized eyes. METHODS: Intraoperative titrated intravitreal injection of balanced salt solution (BSS) through pars plana was done using a 30G needle hooked to a 1 cc syringe to build up the vitreous pressure. RESULTS: Five eyes of five patients who had previous vitrectomy were given intraoperative injection. This led to the prevention of lens–iris diaphragm retropulsion and routine completion of phacoemulsification. The preoperative visual acuity was < 6/60 in all patients. The postoperative visual acuity was 6/9 or better in all patients, except in one patient which was 6/60, which is explained by diabetic ischemic maculopathy. Neither injection-related intraoperative nor postoperative complications were noted. CONCLUSION: Challenges of phacoemulsification in vitrectomized eyes can be prevented by a simple titrated intraoperative injection of BSS intravitreally through pars plana.