Pars Plana Anterior Vitrectomy for the Anterior Segment Surgeon

  • Lisa Brothers Arbisser


Every cataract surgeon encounters unplanned vitreous loss. Eyes respond differently, and surgeons are not automatons. Ideally, we will not lose vitreous the same way twice; a rarely achieved yet lofty goal. It behooves us to have a plan in mind, tools with which to execute the plan at the ready, to be prepared for contingency for every case. The earlier a complication is recognized and the stage of complication limited, the better the result. Rarely do we breach the posterior capsule without rupturing the anterior hyaloid. When limited to this stage, optimal outcomes uniformly result assuming implant stability is achieved. Rupture of the anterior hyaloid membrane with prolapse of vitreous into the anterior segment changes the risk of late complications. Once vitreous is lost through incisions, there is a greater likelihood of retinal tear or detachment; another set of actions is indicated. Depending upon the timing, this may be associated with residual lens remnants.


Posterior Capsule Scrub Nurse Clear Corneal Incision Anterior Vitrectomy Vitreous Loss 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 10.1

(MP4 20454 kb)

Video 10.2

(MP4 10633 kb)

Video 10.3

(MP4 8910 kb)

Video 10.4

(MP4 12621 kb)

Video 10.5

(MP4 56778 kb)

Video 10.6

(MP4 12256 kb)

Video 10.7

(MP4 45258 kb)

Video 10.8

(MP4 5805 kb)

Video 10.9

(MP4 611 kb)

Video 10.10

(MP4 32731 kb)

Video 10.11

(MP4 9527 kb)

Video 10.12

(MP4 3923 kb)

Video 10.13

(MP4 53473 kb)


  1. 1.
    Worst JGF, Los LI. Cisternal anatomy of the vitreous. Amsterdam/New York: Kugler Publications; 1995.Google Scholar
  2. 2.
    Arbisser LB, Charles S, Howcroft M, Werner L. Management of vitreous loss and dropped nucleus during cataract surgery. Ophthalmol Clin North Am. 2006;19(4):495–506.PubMedGoogle Scholar
  3. 3.
    Peyman GH. Triamcinolone acetonide as an aid to visualization of the vitreous. Retina. 2000;20(5):554.CrossRefPubMedGoogle Scholar
  4. 4.
    Burk SE, DaMata AP, Snyder ME. Visualizing vitreous using Kenalog suspension. J Cataract Refract Surg. 2003;29:645–51.CrossRefPubMedGoogle Scholar
  5. 5.
    Burk SE, DaMata AP, Snyder ME. Identifying the vile humor. Video J Cataract Sur. 2002;18.Google Scholar
  6. 6.
    Lincoff H, Zweifach P, Brodie S. Inraocular injection of lidocaine. Ophthalmology. 1985;92:1587–91.CrossRefPubMedGoogle Scholar
  7. 7.
    Osher RH. Slow motion phacoemulsification approach. J Cataract Refract Surg. 1993;19:667.CrossRefPubMedGoogle Scholar
  8. 8.
    Agarwal A, Jacob S, Agarwal A, Narasimham S, Kumar D, Agarwal A. Glued intraocular lens scaffolding to create an artificial posterior capsule for nucleus removal in eyes with posterior capsule tear and insufficient iris and sulcus support. J Cataract Refract Surg. 2013;39:326–33.CrossRefPubMedGoogle Scholar
  9. 9.
    Gimbel HV, DeBroff BM. Intraocular lens optic capture. J Cataract Refract Surg. 2004;40:200–6.CrossRefGoogle Scholar
  10. 10.
    Arbisser LB. Safety of intracameral moxifloxacin for prophylaxis of endophthalmitis after cataract surgery. J Cataract Refract Surg. 2008;34:1114–20.CrossRefPubMedGoogle Scholar
  11. 11.
    Vanner EA, Stewart MW. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: a systematic review and meta-analysis. Am J Ophthalmol. 2011;152:345–57.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2017

Authors and Affiliations

  • Lisa Brothers Arbisser
    • 1
  1. 1.Moran Eye Center, University of UtahSalt Lake CityUSA

Personalised recommendations