Asteroid hyalosis removal during phacoemulsification: an anterior approach

PurposeThe aim of this study was to evaluate the safety and efficacy of asteroid hyalosis (AH) removal by means of anterior vitrectomy through posterior capsulorhexis during phacoemulsification.Patients and methodsThe study was conducted on 16 eyes of 16 cataractous patients associated with AH. Phacoemulsification was performed, followed by removal of the AH through posterior capsulorhexis by means of anterior vitrectomy and before intraocular lens implantation. Patients were examined at 1 day, 1 week, 1, 3, and 6 months postoperatively. Data were analyzed using paired t-tests to compare the preoperative and postoperative uncorrected visual acuity and corrected visual acuity. The basic postoperative parameters at each follow-up visit were assessment of uncorrected visual acuity and corrected visual acuity and slit-lamp examination to evaluate the corneal condition and to detect any postoperative inflammation. The disappearance of AH was confirmed clinically using slit-lamp examination.ResultsAll patients in this study showed a statistically significant improvement in postoperative visual acuity (P=0.001) at the last follow-up visit. One patient who had diabetic retinopathy and maculopathy showed deteriorated visual acuity at the last postoperative visit (P=0.2). Two patients had suboptimal best-corrected visual acuity after 6 months due to the presence of cellophane maculopathy detected clinically and using ocular coherence tomography (OCT) examination (P=0.01).ConclusionRemoval of AH by means of anterior vitrectomy during phacoemulsification through a posterior capsulorhexis is safe and effective and enables the surgeon to treat undiagnosed missed retinal lesions that were not obvious preoperatively