To evaluate safety and efficacy of clear corneal approach irido-zonulo-hyaloido-vitrectomy, which we defined it “mini-vitrectomy”, in the management of pseudophakic aqueous misdirection

: In this retrospective, non-comparative interventional case series 24 eyes with diagnosis of pseudophakic aqueous misdirection were enrolled. They underwent mini-vitrectomy, a simple technique that via a clear cornea incision, iridotomy, zonulectomy, and hyaloidectomy, and limited anterior vitrecotmy is performed. Main outcome measure was reformation of the anterior chamber, evaluated at days 1, months 1, 3, 6, and 12.

: Mean age of patients was 75.3 ± 11.3 years (range, 47 to 90), and 13 (54.2%) were female. Anterior chamber depth was deep In 22 patients (91.7%) a day after the surgery. One patient had recurrence of the condition one month after the surgery that was controlled by twice weekly dose of atropine. Mean intraocular pressure (IOP) was 30.3 ± 11.9 at presentation on 2.67 ± 1.09 antiglaucoma medications. IOP decreased significantly to 16.3 ± 6.7, 14.6 ± 7.4, 16 ± 6.3, 17 ± 8.3, and 14.5 ± 4.6 mmHg at day 1, month 1,3,6,and 12 respectively (all Ps in comparison to baseline = 0.001). Mean BCVA Changed from 1.78 ± 0.82 logMAR at baseline to 1.52 ± 0.93 at the 12 months (P=0.733).

mini-vitrectomy is a simple, safe and effective procedure in management of pseudophakic aqueous misdirection and could be adopted by all ophthalmologists who are involved in glaucoma management and are not comfortable with pars plana vitrectomy approach.