Safety and effectiveness of an iris hook assisted phacoemulsification in vitrectomized eyes

AIM:To introduce a simple iris hook assisted phacoemulsification(PE)procedure and evaluate the safety and efficacy of it in completely vitrectomized eyes.METHODS:A single centre study which included 65 previously completely vitrectomized eyes of 62 patients who underwent cataract surgery.Patients were randomly divided into 3 groups.Patients received PE,and intraocular lens(IOL)implantation with the assistance of iris hook(SynergetiesTM)as group A(25 eyes);patients who received PE assisted with a 25 G pars plana irrigation as group B(20 eyes),and patients who received PE performed without the help of any instrument as group C(20 eyes).Main outcome measures were surgery duration,Ultrasound(U/S)total time,endothelial cell density(ECD),cumulative dissipated energy(CDE)and complications of the procedures.RESULTS:With the help of iris hook,the patients in group A had the lowest ECD loss rate(0.07±0.03,0.09±0.03,and 0.10±0.03,P<0.05),shortest CDE(12.2±4.1,15.8±6.0,and 16.0±6.0,P<0.05)and U/S total time(36.6±13.0 s,46.3±16.4 s,and 47.6±16.1 s,P<0.05),and minimal incidence of complications.The longest surgery duration was in group B(19.4±1.6 min)and maximum complications rate in group C(20%miosis,10%posterior capsular tears,5%zonular dialysis,5%cystoid macular edema).While best-corrected visual acuity(BCVA),intraocular pressure(IOP)and ECD did not show a significant difference among the three groups.CONCLUSION:Without prolonged surgery duration,the iris hook assistant method can minimize heat generation during surgery and incidence of complications,which transfer the challenged PE in vitrectomized eyes into a regular surgery.It does not need any change in the hydrodynamic parameters and in the bag PE technique,easy to operate even for junior surgeons.