Cataract surgery combined with vitreoretinal surgery in multiple vitreoretinal diseases

Poster Details

First Author: D.Beselga PORTUGAL

Co Author(s):    J. Castro e Sousa   S. Mendes   A. Neves   J. Campos   M. Castro   D. Castanheira

Abstract Details

Purpose:

To present the functional results and complications associated with combined phacoemulsification and pars plana vitrectomy (PPV) in different vitreoretinal diseases.

Setting:

Ophthalmology Department, Hospital Center Leiria-Pombal, Portugal.

Methods:

Retrospective study that included 216 eyes of a group of patients with a mean age of 65.8 years, with cataract and the following vitreoretinal diseases: 108 with proliferative diabetic retinopathy (PDR) with or without hemovitreous, 46 with epimacular membrane (EMM), 34 with retinal detachment (RD), 8 with uveitis, 8 with macular hole (MH), 8 with asteroides hyalosis and 4 with central retinal vein occlusion (CRVO). The surgical technique consisted of placing first the infusion cannula for pars plana vitrectomy (PPV) then to perform phacoemulsification through transparent corneal microincisions with placement of intraocular lens (IOL) in the capsular bag followed by central/peripheral PPV with procedures varying depending on the vitreoretinal pathology.

Results:

Preoperative mean best corrected visual acuity (BCVA) was 0.039 and mean postoperative BCVA at six months was 0.34 (student t test: p <0.00003). The average postoperative refraction assessed at 6 months was +0.3 D, but in the case of EMM was -0.85D, in PDR -0.6D and +2.0 D in RDs. Complications included 3 cases of RD, 2 cases of anterior synechia, 2 cases of IOL capture, 2 inflammatory membranes, 1 case of silicone emulsification and 2 cases of intraocular hypertension (IOHT). No cases of endophthalmitis or posterior capsule opacification.

Conclusions:

Phacovitrectomy appears to be safe, efficient and to have good functional results in patients with multiple vitreoretinal pathology and cataract that significantly decreases visual acuity. It can reduce the total operative time and costs.In our experience intraoperative and postoperative complications do not seem to occur more frequently compared to the procedures performed separately. The refractive results of our patients seem to indicate a tendency to postoperative myopization. FINANCIAL DISCLOSURE?: No