Posters

Evaluation of safety and efficacy of cataract surgery combined with pars plana vitrectomy in cases of retinal diseases using a femtosecond laser

Poster Details

First Author: I.Conrad-Hengerer GERMANY

Co Author(s):    M. Curshmann   G. Auffarth                 

Abstract Details

Purpose:

To assess intra- and postoperative anterior chamber stability and IOL position during sutureless 23 gauge pars-plana-vitrectomy (PPV) with gas endotamponade after standard cataract surgery or Femtosecond laser-assisted cataract surgery. All complications were documented and further additional surgical steps to regain a stable IOL-position or anterior chamber were analyzed. IOL-centration and lens tilt were assessed using Scheimpflug imaging and 360° overlap of capsulorrhexis/capsulotomy and IOL optic was observed.

Setting:

The study was performed at Ruprecht-Karls-University Eye Hospital, Heidelberg, Germany, All patients had to undergo pars plana vitrectomy, because of a retinal disease, in combination with cataract surgery and volunteered for the study. The trial received ethical committee approval and all aspects of the Helsinki Declaration were observed.

Methods:

After randomization 65 eyes were treated by laser-assisted cataract surgery and the other 66 eyes had phacoemulsification using pulsed ultrasound energy and intraocular lens implantation. Both surgeries were followed by a PPV with gas endotamponade. All intraoperative complications were documented. The used effective phaco time and further additional surgical steps to regain a stable IOL-position or anterior chamber were analyzed. IOL-centration and lens tilt were assessed using Scheimpflug imaging. Furthermore the 360° overlap of capsulorrhexis/capsulotomy and IOL optic was observed. Endothelial cell count, corneal pachymetry, macular thickness and PCO was measured, respectively, until 12 months postoperative follow-up.

Results:

The study group with 65 femtosecond laser-assisted cataract surgeries (LCS group) showed a significant lower EPT in comparison to the standard cataract group. After gas tamponade the anterior chamber was more stable and less additional surgical steps were necessary to regain a stable IOL-position. All patients in the LCS group showed a 360° overlap of capsulotomy and IOL optic after gas tamponade but in the standard group only 45 of 66 eyes showed 360° overlap of capsulorrhexis and IOL optic after gas tamponade and 15 needed repositioning of the IOL at the end of surgery.

Conclusions:

Cataract surgery is one of the most successful procedures in medicine; however, the combination of PPV with standard cataract surgery often shows intraoperative and early post OP complications due to instable anterior chamber situations. The capsulorhexis carried out by a Femtosecond Laser guarantees a perfect 360° overlap of the capsulotomy with the IOL. This should protect from any complications associated with an intraoperative filling of the vitreous body with expanding gas/air fill.

Financial Disclosure:

receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented, travel has been funded, fully or partially, by a competing company, travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, research is funded, fully or partially, by a competing company, research is funded, fully or partially, by a company producing, developing or supplying the product or procedure presented, receives consulting fees, retainer, or contract payments from a competing company