PMC3617892_01
Left eye before surgery. Band keratopathy, posterior synechiae and cataract.
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PMC3617892_01_cop-0004-0032-g01.jpg
F1
a Iris retractors. b Anterior inflammatory membrane removal. c Identification of vascular retrolental membrane. d Vasculature cauterization with diathermy. e Posterior membranectomy and automated anterior vitrectomy. f Intraocular lens implantation in the capsular bag.
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F2
Taking his medical history, literature, uveitis and anterior segment services experience into account, a slow-motion phacoemulsification with iris-retractors (fig. 2a) was performed after removing the anterior inflammatory membrane attached to the anterior capsule (fig. 2b). A challenging surprise appeared after the cataract was removed: an opaque-vascular retrolental membrane attached to the posterior capsule (fig. 2c). The membrane vasculature was cauterized with diathermy (fig. 2d) and primary posterior capsulotomy and membranectomy were performed, followed by a limited anterior vitrectomy (fig. 2e). IOL was chosen because of its folding ability, a successful in-the-bag implantation and its uveal compatibility (fig. 2f). In addition to postoperative antibiotics, anti-inflammatory and immunosuppressive medication was continued (topical prednisolone and nepafenac, and oral methotrexate and deflazacort) and periocular betamethasone was injected three days before surgery to avoid postoperative inflammatory complications.
Left eye after surgery. In-the-bag IOL.
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F3
The patient had close monitoring with clinical (fig. 3) and echographical evaluations after surgery.