Name of the Procedure:

Paracentesis of anterior chamber of the eye; with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection. Common name(s): Anterior chamber paracentesis, discission of anterior hyaloid membrane.

Summary

Anterior chamber paracentesis is a surgical procedure involving the removal of fluid from the front part of the eye, which may include the removal of vitreous gel and the breaking of the anterior hyaloid membrane. This procedure can be accompanied by the injection of air into the chamber.

Purpose

The procedure is primarily performed to reduce intraocular pressure, clear hemorrhage, or remove inflammatory debris from the eye's anterior chamber. The goal is to improve vision, relieve pain, and prevent further eye damage.

Indications

• Acute angle-closure glaucoma with elevated intraocular pressure.
• Hyphema (bleeding inside the eye).
• Persistent inflammation or infection in the eye's anterior chamber.
• Complications from prior eye surgeries.
• Vitreous prolapse into the anterior chamber.

Preparation

• The patient may be advised to fast for a few hours before the procedure, especially if sedation will be used.
• Preoperative eye drops may be prescribed to reduce intraocular pressure.
• Blood tests, eye examinations, and imaging tests may be required to assess the condition of the eye.

Procedure Description

1. The patient is placed in a reclining position.
2. Anesthesia: Local anesthetic eye drops are applied to numb the eye.
3. A small incision is made in the eye's cornea.
4. A fine needle or surgical knife is used to access the anterior chamber.
5. Fluid is drained, potentially alleviating pressure and removing debris.
6. If necessary, the vitreous gel is removed, and the anterior hyaloid membrane is dissected.
7. Air may be injected into the chamber to maintain its shape.
8. The incision is closed, and antibiotic eye drops are applied to prevent infection.

Duration

The procedure typically takes 30 minutes to an hour.

Setting

It is usually performed in an outpatient surgical center or a hospital.

Personnel

• Ophthalmologist or eye surgeon.
• Surgical nurse.
• Anesthesiologist (if sedation is used).

Risks and Complications

• Infection.
• Bleeding.
• Increased intraocular pressure.
• Damage to surrounding eye structures.
• Postoperative inflammation.
• Corneal decompensation.

Benefits

• Reduction of intraocular pressure.
• Improved vision.
• Relief of pain and discomfort.
• Prevention of further eye damage.

Recovery

• Use of prescribed antibiotic and anti-inflammatory eye drops.
• Instructions to avoid rubbing the eye.
• Follow-up appointments to monitor eye pressure and healing.
• Most patients return to normal activities within a week, though complete recovery may take several weeks.

Alternatives

• Medicated eye drops to reduce intraocular pressure.
• Laser procedures such as YAG laser capsulotomy.
• More extensive surgical interventions for severe cases.

Patient Experience

During the procedure, the patient may feel slight pressure but generally no pain due to local anesthesia. Post-procedure, the eye may be sore, and vision may be temporarily blurry. Pain management involves over-the-counter pain relievers and prescribed eye drops to ease discomfort and promote healing.