Combined pars plana vitrectomy (PPV) and phacoemulsification (phaco) vs PPV and deferred phaco for patients with macular hole: one year outcomes

Session Details

Session Title: Presented Poster Session: Equipment, Instrumentation & Surgical Devices

Venue: Poster Village: Pod 1

First Author: : D.Lucena BRAZIL

Co Author(s): :    R. Jorge   K. Viana   C. Gordilho   F. Almeida   I. Scott   A. Messias        

Abstract Details

Purpose:

To compare outcomes for combined procedure: pars plana vitrectomy (PPV) and phacoemulsification (phaco) versus PPV and deferred phaco in patients with macular hole (MH) without dense cataract.

Setting:

Prospective Randomized Clinical Trial that included macular hole patients from a Tertiary Referral Center

Methods:

Sixty-five patients with MH with lens opacity less than grade II cortical/nuclear (LOCS III) were randomly assigned to: group PHACO-PPV or PPV-D-PHACO with deferred PHACO.Ophthalmologic evaluation performed at baseline and at 1, 3, 6, 9, and 12 months following PPV included ETDRS best-corrected visual acuity (BCVA); intraocular pressure (IOP); MH height measured by spectral domain optical coherence tomography; and specular microscopy (Konan Medical Inc., USA). In Group 2, phaco was performed at any time post-PPV if the cataract severity was LOCS subcapsular ≥1 or nuclear ≥3 or cortical ≥3, or if any decrease in visual acuity attributable to the cataract.

Results:

65 patients (33 in PHACO-PPV and 32 in PPV-D-PHACO) completed 12 months of follow-up. Mean ± SE BCVA (logMAR) was 0,92 ± 0,04 and 0,90 ± 0,04 at baseline and improved significantly to 0,60 ± 0,05 and 0,58 ± 0,05 at month 12 (p<0.0001) in Groups 1 and 2, respectively. There was no significant difference between the groups for IOP or endothelial cell density at baseline or at 12 months. There was also no difference between the groups in baseline mean MH height. MH closure rate was 72% and 75% in groups 1 and 2, respectively (p = 0,834, chi-square test).

Conclusions:

Combined PPV and phaco was associated with similar BCVA outcomes at 1 year when compared to PPV and deferred phaco in patients with MH.

Financial Disclosure:

None