Background: We sought to verify the efficacy and safety of transconjunctival 23-\ngauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal\nof dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative,\ninterventional study of 31 consecutive cases of patients who underwent\n23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens\nfollowing complicated cataract surgeries using our bimanual technique was conducted.\nThe main outcomes measured included best-corrected visual acuity (BCVA),\npreoperative intraocular pressure (IOP), postoperative IOP and postoperative complications.\nResults: In all 31 cases included in this study, those dense posteriorly dislocated\ncrystalline lenses were successfully removed. The enrolled patients consisted\nof 17 males and 14 females with a mean age of (75.84 �± 6.17) years (range 59 - 90).\nThe mean follow-up length was (7.61 �± 1.87) months with a range of 6 months to 1\nyear. The mean preoperative BCVA was 0.22 �± 0.11 logMAR system, and the postoperative\nBCVA was 0.33 �± 0.07 logMAR system after 6 months of follow-up. The\nmean operative time was 46.32 �± 4.80 minutes with a range of 38.00 to 57.00 minutes.\nAll of the conjunctival incisions self-closed within the first week with no wound\nleakage or hemorrhage. The postoperative complications were relatively rare. Conclusions:\nThe removal of dense posteriorly dislocated crystalline lens might be a challenge\nfor micro-incision vitrectomy. Our bimanual technique was proved to be an effective\nand safe method for those particular dense lenses using 23-gauge alone.
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