Purpose: To evaluate the use of 23 gauge pars plana vitrectomy in management of dropped
nucleus after phacoemulsification by two different techniques according to dropped nucleus size
and consistency. Patients and Methods: Thirty eyes of thirty patients with dropped nucleus
during phacoemulsification divided into two groups; each group consists of fifteen eyes. Group < br />A includes 15 eyes performed using transconjunctival sutureless 23 gauge pars plana
vitrectomy system with the use of PFCL and full removal of all dropped nuclear fragment by the
vitreous cutter .Group B includes 15 eyes performed using transconjunctival suture less 23
gauge pars plana vitrectomy system with the use of PFCL and removal of some dropped
nuclear fragment by the vitreous cutter while the others were removed through a limbal incision
or scleral frown. Results: In group A we found that the mean VA was improved from 0.3
preoperatively to 0.3, 0.7 and 0.7 at 1st week, 3rdand 6 months postoperatively respectively. In
group B we found that the mean VA was improved from 0.2 preoperatively to 1st week, 3rd and
6 months postoperatively respectively. In group A we found that the mean IOP was changed
from 16 mmHg at the baseline to 19 mmHg, 17 mmHg and 16 mmHg at1st week, 3rd and 6
months postoperatively respectively. In group B we found that the mean IOP was changed from
18 mmHg at the baseline to 17 mmHg, 18 mmHg and 16 mmHg at 1st week, 3rd and 6 months
postoperatively respectively. Conclusion: Twenty three gauge pars plana vitrectomy was
successful in cases of dropped fragments or quadrants and being soft cataract, while if it was all
of the nucleus we can minimize its size by the vitreous cutter, and removing the remaining parts
through a limbal wound or scleral frown trying to preserve the sutureless procedure as possible.