Posterior synechia of the iris after combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation.
OBJECTIVE
Combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation has become a widely accepted treatment for cataracts in patients with vitreoretinal diseases. We examined factors influencing the development of posterior synechia after this triple procedure.


METHODS
One hundred and three patients (107 eyes) were evaluated. The frequency of postoperative posterior synechia, the preoperative diagnosis, whether gas tamponade was used, and the type of lens implanted were reviewed.


RESULTS
Twenty-one eyes (19.6%) developed posterior synechia, and the highest rate (12/39 eyes, 30.8%) was in patients with proliferative diabetic retinopathy. Posterior synechia was more frequent after gas tamponade (28.1%) than in eyes without tamponade (10.1%). In proliferative diabetic retinopathy (PDR) patients, fibrin deposition and the amount of retinal photocoagulation were causative factors for posterior synechia.


CONCLUSIONS
Factors promoting postoperative synechia after the triple procedure included (1) the existence of PDR, (2) expanding gas tamponade, (3) fibrin deposition in PDR, and (4) the amount of photocoagulation in PDR.
Shinoda
K
K
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
O'hira
A
A
Ishida
S
S
Hoshide
M
M
Ogawa
L S
LS
Ozawa
Y
Y
Nagasaki
K
K
Inoue
M
M
Katsura
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D006801:Humans; D007499:Iris Diseases / Q000209:etiology*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D000267:Tissue Adhesions; D014821:Vitrectomy / Q000009:adverse effects*