Evaluation of the disc shaped lens in the combined cataract and vitrectomy surgery

Introduction
Evaluation of Acrimed LENTIS UNICO LU-800 RZI discoid lens in the combined cataract and vitrectomy surgery.

Material and methods
Ten patients that underwent combined cataract and vitrectomy surgery between January and April 2007 were included in the prospective study. There were 8 female and 2 male patients with the mean age of 58.4±18.7 years in the study group. Data including age, sex, indications for surgery were collected with a special form. Furthermore, difficulty of lens implantation, retinal periphery visualization during vitrectomy, and retinal periphery visualization in the follow up ophthalmoscopy were evaluated with a special scale ranging from 0 to 5 (0 = impossible, 1 = very difficult, 2 = difficult, 3 = moderate, 4 = easy, 5 = very easy).

Results
The difficulty of the anterior segment surgery was graded 3.1±0.74. Visualization of the retinal periphery in the vitrectomy was ranked 4.8±0.42. In the postoperative follow up ophthalmoscopy visualization of the peripheral retina was scored as 4.4±0.7. The most severe complication observed intraoperatively was discoid lens dislocation into the vitreous cavity. Postoperatively there was a case of a malignant glaucoma-like syndrome that required a second surgery.

Conclusions
In our opinion the discoid lens yields a very good visibility of the peripheral retina during vitreoretinal procedures and in the follow up ophthalmoscopy. We do not recommend this lens for routine cases, because of the difficult implantation and the relatively high number of complications is observed. It can be considered in some selected eyes when maneuvers in the peripheral retina or laser therapy in the future are planned.