Visual outcome in management of posterior capsular thickening by anterior vitrectomy through limbal route corrected

Aim: to evaluate the safety efficacy and visual outcome in the management of primary posterior capsulotomy through limbus. methods: this prospective intervention case series was conducted in institute of ophthalmology/mayo hospital lahore from january 2012 to january 2014. complete ophthalmic examination of anterior and posterior segments including assessment of type of posterior capsular opacification,visual acuity,intraocular pressure and b scan were carried out. this study included 30 eyes of 28 patients who underwent anterior vitrectomy and capsulotomy performed through limbus. mean follow up was 6 months. surgical techniques,per operative and postoperative complications were recorded. final visual acuity was also recorded. outcome measures were assessment of visual acuity and complications. results: the study included 30 eyes of 28 patients with posterior capsular thickening who were treated with anterior vitrectomy with capsulotomy through limbal approach. there were 14(47%) male and 16(53%) female eyes. the mean follow up was 6 months (ranges from 3 to 24 months). in 12 eyes the intraocular lenses were implanted including 4 eyes (33%) with anterior chamber lens implantation and in 8 eyes (67%) with posterior chamber lens implantation. visual acuity was improved in all eyes 6/60 in three (10%) eyes,6/36 to 6/24 in one (3.3%) eyes 6/18 to 6/12 in sixteen (55%),6/9 to 6/6 in seven eyes (23%). mean intraocular pressure ranged from 8 to 28. complications included moderate uveitis in seven eye (23%),two (6.6%) eyes developed glaucoma,lens tilt occurred in three eyes (30%) due to poor support of posterior capsule,hypotony in two eyes (6.6% ),vitreous hemorrhage in four (13%) eyes and insufficient capsular opening was noted in 2 eyes (6.6%) eyes. we found no case of recurrent posterior capsular opacification,retinal detachment and endopthalmitis. no eye developed recurrent posterior capsular thickening. conclusion: anterior vitrectomy with posterior capsulotomy through limbus appears to be a safe and effective procedure to improve visual acuity in patient with thick posterior capsular thickening.