Joint ESCRS/EURETINA symposium on vitreoretinal complications of anterior segment surgery

The vexed question of vitreoretinal complications of anterior segment surgery drew a large and appreciative audience to the joint ESCRS-EURETINA symposium chaired by Francesco Bandello, president of EURETINA and Roberto Bellucci, president of the ESCRS.

The session was opened by Oliver Findl of Austria who discussed the issue of posterior capsular rupture and vitreous complications. He noted that  posterior capsular rupture is the most common intraoperative complication during cataract surgery occuring at a rate of between 1.9 per cent to five per cent and is widely regarded as the benchmark complication to judge the quality of such surgery.

Morten La Cour from Denmark focused his presentation on pseudophakia and retinal detachment. He told the audience that it was meaningless and misleading to describe the risk of pseudophakic retinal detachment as a fixed percentage without taking the time dimension as well as the inherent risk of the operated eye into consideration.

Rudy Nuijts from the Netherlands gave a comprehensive overview of current clinical practice in Europe and further afield in the prevention and management of cystoid macular oedema. Dr Nuijts said that the ongoing PREMED multicentre study which is being funded by the ESCRS should help to answer some critical questions relating to the prevention and management of CME after cataract surgery. At the end of the study, clinicians should have a much clearer picture as to the optimum postoperative treatment regimen for cataract patients with and without diabetes mellitus, he said.

Gisbert Richard from Germany shared his thoughts on surgical options for the rare complications of severe choroidal detachment or suprachoroidal haemorrhage after anterior segment surgery. He said that reconstruction of the choroidal and retinal anatomy usually results in a rapid and lasting functional improvement and that special care should be taken with anterior segment surgery in myopic, hyperopic or aphakic patients. He also noted that a surgical intervention may still be beneficial even in cases of high-graded or total choroidal detachment with or without retinal detachment.

 The symposium was rounded off by Sebastian Wolf from Switzerland on techniques for handling a dropped nucleus and Ursula Schmidt-Erfurth from Austria who discussed the retina after anti-VEGF injections at the time of cataract surgery.