Vitreous Prolapse in the Anterior Chamber
Vitreous in the anterior chamber may lead to chronic intraocular inflammation, corneal edema, glaucoma, and CME. The pupil may be distorted by vitreous adherent to the incision. Inflammation, symptoms of glare due to an exposed IOL edge, and patient dissatisfaction with the appearance of the iris may prompt intervention. In symptomatic patients, Nd:YAG laser vitreolysis or anterior vitrectomy may be considered when the response to topical anti-inflammatory therapy is inadequate. If the vitreous extends through the incision to the ocular surface, a vitrectomy is warranted. The exposed vitreous may act as a wick, enabling bacteria to enter the eye and increasing the risk of endophthalmitis. In cases of suspected corneal compromise, a posterior vitrectomy approach may be preferable to an anterior approach to reduce surgical trauma to the cornea.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.