J Korean Ophthalmol Soc.  2009 Jul;50(7):1015-1021. 10.3341/jkos.2009.50.7.1015.

Phacoemulsification in Previously Vitrectomized Eyes; Results of a 5-Year Period in Surgical Outcome

Affiliations
  • 1Department of Ophthalmology, School of Medicine, Chonbuk National University, Jeonju, Korea. key@chonbuk.ac.kr

Abstract

PURPOSE
To compare the incidence of complications and the outcome of phacoemulsification surgery in patients with and without previous vitrectomy. METHODS: We retrospectively investigated 60 patients in a study group that received phacoemulsification with posterior chamber IOL implantation (PC-IOL) in the vitrectomized eye and 60 patients in a control group that received only phacoemulsification with PC-IOL implantation from January 2003 to December 2007. The interval from PPV to cataract extraction, sex, age, type of cataract, intraoperative and postoperative complications, pre- and postoperative refraction were reviewed. RESULTS: The most common indication of pars plana vitrectomy was diabetic retinopathy. Nucleosclerosis was the most common type of cataract. The most common intraoperative complication was posterior capsular rupture, but there was no statistical significance when compared with the control group (p=0.116). In addition, the most common postoperative complication was posterior capsular opacity. After phacoemulsification, the rate at which a BCVA of 0.5 or better was obtained was lower in the study group than the control group. The spread between actual and expected refraction showed no statistically significant difference when compared with the control group (p=0.309). CONCLUSIONS: Experienced surgeons can safely perform phacoemulsification and PC-IOL implantation in previously vitrectomized eyes. However, the outcome of visual acuity is limited by vitreoretinal pathology that requires vitrectomy.

Keyword

Cataract; Pars plana vitrectomy; Phacoemulsification; Vitrectomized eye

MeSH Terms

Cataract
Cataract Extraction
Diabetic Retinopathy
Eye
Humans
Incidence
Intraoperative Complications
Phacoemulsification
Postoperative Complications
Retrospective Studies
Rupture
Visual Acuity
Vitrectomy

Figure

  • Figure 1. Type of cataract in study and control group.

  • Figure 2. Scattergram showing the relationship between logarithm of the minimum angle of resolution (LogMAR) visual acuity before and after phacoemulsification in eyes with previous pars plana vitrectomy (PPV) and without PPV.


Reference

References

1. Melberg NS, Thomas MA. Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age. Ophthalmology. 1995; 102:1466–71.
Article
2. Blodi BA, Paluska SA. Cataract after vitrectomy in young patients. Ophthalmology. 1997; 104:1092–5.
Article
3. Lucke KH, Foerster MH, Laqua H. Long-term results of vitrectomy and silicone oil in 500 cases of complicated retinal detachment. Am J Ophthalmol. 1987; 104:624–33.
4. Federman JL, Schubert HD. Complications associated with the use of silicone oil in 150 eyes after retina-vitreous surgery. Ophthalmology. 1988; 95:870–6.
Article
5. Borislav D. Cataract after silicone oil implantation. Doc Ophthalmol. 1993; 83:79–82.
Article
6. Ahfat FG, Yuen CH, Groenewald CP. Phacoemulsification and intraocular lens implantation following pars plana vitrectomy; a prospective study. Eye. 2003; 17:16–20.
Article
7. Biro Z, Kovacs B. Results of cataract surgery in previously vitrectomized eyes. J Cataract Refract Surg. 2002; 28:1003–6.
8. Pinter SM, Sugar A. Phacoemulsification in eyes with past pars plana vitrectomy: case-control study. J Cataract Refract Surg. 1999; 25:556–61.
9. Hotta K. Postoperative refractive error of secondary intraocular lens implantation after simultaneous vitrectomy and lensectomy. Ophthalmic Surg Lasers Imaging. 2007; 38:336–8.
Article
10. Treumer F, Bunse A, Rudolf M, Roider J. Pars plana vitrectomy, phacoemulsification and intraocular lens implantation. Comparison of clinical complications in a combined versus two-step surgical approach. Graefes Arch Clin Exp Ophthalmol. 2006; 244:808–15.
Article
11. Chang MA, Parides MK, Chang S, Braunstein RE. Outcome of phacoemulsification after pars plana vitrectomy. Ophthalmology. 2002; 109:948–54.
Article
12. Misra A, Burton BL. Incidence of intraoperative complications during phacoemulsification in vitrectomized and nonvitrectomized eyes: Prospecive study. J Cataract Refract Surg. 2005; 31:1011–4.
13. Biro Z, Kovacs B. Results of cataract surgery in previously vitrectomized eyes. J Cataract Refract Surg. 2002; 28:1003–6.
14. Sudan R, Muralidhar R, Sharma V. Healon5 sandwich technique for phacoemulsification in vitrectomized eyes. J Cataract Refract Surg. 2008; 34:18–20.
Article
15. Grusha YO, Masket S, Miller KM. Phacoemulsification and lens implantation after pars plana vitrectomy. Ophthalmology. 1998; 105:287–94.
Article
16. Kim HW, Hur J, Yoon IH, Ku YM. The surgical outcome of cataract extraction after pars plana vitrectomy. J Korean Ophthalmol Soc. 1999; 40:2481–7.
17. Shioya M, Ogino N, Shinjo U. Change in postoperative refractive error when vitrectomy is added to intraocular lens implantation. J Cataract Refract Surg. 1997; 23:1217–20.
Article
18. Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery. Ophthalmic Surg Lasers. 2000; 31:271–5.
Article
19. Kim EY, Ahn JH, Lew HM, Yang HS. Effect of vitrectomy on IOL calculation for cataract surgery: Study of vitrectomized eyes. J Korean Ophthalmol Soc. 2008; 49:1759–64.
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr