TRANSLIMBAL INTRAOCULAR ENDOILLUMINATION DURING CATARACT SURGERY

Abstract

The aim of this study is to describe a technique for intraoperative examination of macula and posterior capsule during phacoemulsification surgery in eyes with dense cataract. This work was done in Ophthalmology Department, Hamad Medical Corporation, Doha-Qatar on 36 patients (42 Eyes) with dense cataract and obscured fundus view. No data were recorded for macular status, and preoperative macular assessment was not conclusive by Ophthalmoscopy, B-Scan Ultrasound, and Optical Coherence Tomography (OCT). All patients were consented for cataract surgery plus additional vitreoretinal surgical procedure if indicated. Fundus examination done during phacoemulsification by translimbal insertion of endo-light probe after Irrigation/Aspiration step prior to lens implantation, capsular-bag expanded by viscoelastic to accommodate probe insert. Posterior capsule status checked by Endolight using microscope lens system only, macula checked by endolight with a vitreoretinal viewing lens system. Forty-two eyes (25 right and 17 left), (27 males, 15 females) in 39 patients were studied. The mean age was 59 years (47-78 years). Fourteen patients (18 eyes) were diabetics. Preoperative Visual Acuity of ≤ 6/60 was recorded in all patients. Cataract Density was graded by fundus visualization and in all cases, only shadow of optic disc and/or major vessels could be seen. Concurrent intravitreal injections was done in eight eyes (19%): seven of them were having Diabetic Macular Edema, and one has hemorrhagic Choroidal Neovascular Membrane (CNVM) due to age related macular degeneration. No complication was recorded in relation to Endoillumination. Posterior Capsule visualization was improved significantly and intracapsular lens implantation was done in all cases In conclusion, translimbal endo-illumination technique improved view to both Macula and posterior capsule during phacoemulsification with subsequent early surgical decision according to endolight findings. No extra incision required.