The Asia-Pacific Journal of Ophthalmology

Asia-Pacific Journal of Ophthalmology:

Issue 1, January/February 2017 Original Study - Clinical

Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases

Lam, Dennis S. C.; Leung, Hiu Ying; Liu, Shu; Radke, Nishant; Yuan, Ye; Lee, Vincent Y. W.



Author Information


From the *Dennis Lam & Partners Eye Center, Central, Hong Kong; †C-MER (Shenzhen) Dennis Lam Eye Hospital, Futian District, Shenzhen, Guangdong, China; and ‡State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China.


Reprints: Dennis S.C. Lam, MD, FRCOphth, C-MER (Shenzhen) Dennis Lam Eye Hospital, Shengtang Building, No. 1 Tairan 9th Road, Chegongmiao, Futian District, Shenzhen, Guangdong, China. E-Mail: dlam.pub.sklo.sysu.cn@gmail.com.



Abstract


Purpose: To study the safety and efficacy of 2-port pars plana anterior and central core vitrectomy (Lam floaterectomy) in combination with phacoemulsification (phaco) and intraocular lens implantation (IOL) for patients with cataract and significant floaters under topical anesthesia.


Design: Retrospective review of the first 50 consecutive cases.


Methods: A standardized treatment protocol was used for patients with cataract and significant floaters (duration >3 months). Lam floaterectomy using 23G valved sclerotomy cannulas and the anterior vitrectomy system of phaco machine was done in combination with phaco and IOL under topical anesthesia. Data analysis included intraoperative and postoperative complications, floaters clearance and patient satisfaction rates.


Results: There were 50 eyes (38 patients) with 11 males 27 females. Twelve patients had bilateral sequential eye surgeries. The mean age was 57.05 ± 10.90 (range, 39-83) years. All patients completed the 3-month follow-up. One eye had mild vitreous hemorrhage at the end of surgery arising from sclerotomy wound oozing. Postoperatively, there was 1 case of transient hypotony and 1 case of congestion at sclerotomy wound. There were no cases of retinal break, retinal detachment, or macular edema. Total floaters clearance rate was 88% (5 cases (10%) of mild residual floaters and 1 case (2%) of floaters recurrence). Patient satisfaction rate was 94% (very satisfied: 80% and satisfied: 14%). Acceptable and unsatisfied rates were 6% and 0% respectively.


Conclusions: The 3-month results of the Lam floaterectomy are encouraging. Further larger-scale, prospective, multicenter studies seem warranted.




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