Novel approach for phacoemulsification during combined phacovitrectomy

PURPOSE To evaluate the safety and efficacy of surgeon's superior sitting position during temporal clear corneal incision (TCCI) phacoemulsification, with a 90° working angle, during combined phacovitrectomy. METHODS Prospective interventional case series were performed on 65 eyes of 63 patients. TCCI phacoemulsification was done in all cases (whether right or left eyes), while the surgeon was sitting superiorly to the operating table. OUTCOME MEASURES INCLUDED Shift in sitting position, keratometric astigmatism, surgically induced astigmatism, posterior capsule integrity, and intraocular lens centration. RESULTS Phacoemulsification was performed completely in all cases (100%). Shift in position to temporal sitting position happened in two cases (3%). The keratometric astigmatism showed mean changes of 1.09 D (0.25-3.75 D) to 0.84 D (0.00-3.25 D) at 1 month, which remained stable at 6 months; 0.84 D (0.16-3.21 D). The surgically induced astigmatism was 0.25 DC (-0.50 to 1.0 DC) at 1 month, which stayed stable at 6 months; 0.25 D (-0.63 D to 0.98 D). Posterior capsular rupture occurred in one case (the second case) (1.5%). The intraocular lens was centered in all cases (100%). CONCLUSION Superior sitting TCCI phacoemulsification, with a wide working angle, during combined phacovitrectomy proved safe and easy, without the burden of changing and disrupting the operative setting. The anatomical and optical outcomes were acceptable.