Cataract surgery combined with transpupillary silicone oil removal through planned posterior capsulotomy.
OBJECTIVE
The purpose of the study was to evaluate transpupillary removal of silicone oil combined with cataract surgery in patients after pars plana vitrectomy.


METHODS
A prospective case-control study.


METHODS
Fifty consecutive patients underwent cataract surgery combined with removal of silicone oil, which had served as intraocular tamponade after pars plana vitrectomy. In 28 patients, silicone oil was removed through a planned posterior capsulotomy, and in 22 patients, silicone oil was removed through pars plana sclerotomies. All patients were operated on by the same surgeon.


METHODS
Pars plana vitrectomy, cataract surgery, and silicone oil removal were performed.


METHODS
Frequencies of retinal redetachment, secondary cataract, cystoid macular edema, and vitreous hemorrhage; visual acuity; intraocular pressure; and duration of surgery and visual rehabilitation were measured.


RESULTS
Frequencies of postoperative vitreous hemorrhage (1 of 28 [4%] vs. 10 of 22 [45%]) and secondary cataract (0 of 28 vs. 6 of 22 [27%]) were significantly lower (P < 0.05; chi-square test), and duration of surgery and visual rehabilitation were significantly shorter (P < 0.01) for patients with transpupillary silicone oil removal than for patients with drainage of silicone oil through pars plana sclerotomies. Rate of retinal redetachment (4 of 28 [14%] vs. 4 of 22 [18%]), time of retinal redetachment (36 +/- 32 postoperative days vs. 54 +/- 65 days), frequency of dislocated intraocular lenses (1 of 28 vs. 0 of 22), and postoperative visual acuity did not vary significantly between the two groups. Persisting comeal endothelial decompensation and clinically significant cystoid macular edema due to cataract surgery were not observed in any patient.


CONCLUSIONS
Silicone oil removal can be combined with cataract surgery. In view of a decreased frequency of postoperative vitreous hemorrhage, reduced rate of secondary cataract, and shorter duration of surgery and visual rehabilitation, transpupillary drainage of silicone oil through a planned posterior capsulotomy compares favorably with removal of silicone oil through pars plana sclerotomies. Retinal redetachment usually occurs within the first 3 postoperative months.
Jonas
J B
JB
Department of Ophthalmology, University Erlangen-Nürnberg, Germany.
Budde
W M
WM
Panda-Jonas
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D004322:Drainage; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011680:Pupil; D012163:Retinal Detachment / Q000601:surgery; D012827:Silicone Oils; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
D012827:Silicone Oils