Results of combined surgery by phacoemulsification and vitrectomy.
BACKGROUND
Eyes scheduled for posterior segment surgery may have cataract, which obscures the visualization of the retina. Surgery may be carried out either by a two-step procedure: i.e., removal of the cataract followed later by posterior segment surgery; or it may be done in a single session: i.e., combined surgery of both the anterior and posterior segments.


OBJECTIVE
To evaluate the outcomes of combined surgery by phacoemulsification and vitrectomy.


METHODS
We retrospectively reviewed the records of 42 patients with coexisting cataract and vitreoretinal disease who underwent combined surgery by phacoemulsification and pars plana vitrectomy at one session.


RESULTS
Indications for surgery were vitreous hemorrhage in 71.4%, retinal detachment in 11.9%, macular hole in 11.9%, and epiretinal membrane in 4.8%. There were no significant intraoperative complications. The main early postsurgical complications were fibrinous formation in 11.9%, elevated intraocular pressure in 23.8%, and recurrent vitreous hemorrhage in 9.5%. There were a few late complications related to phacoemulsification: posterior synechia in 9.5%, posterior capsular opacification in 7.1%, and dislocating intraocular lens in 4.8%. Recurrent retinal detachment occurred in five eyes and rubeoisis iridis in one. Visual acuity was improved in 85.8%, stable in 7.1% and worse in 7.1%.


CONCLUSIONS
Phacoemulsification performed at the time of posterior segment surgery enables good visualization during the vitrectomy, facilitates surgery, and is associated with only minor complications. In cases with cataract and vitreoretinal diseases, combined surgery by phacoemulsification and vitrectomy in one session may be considered.
Pollack
Ayala
A
Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel.
Landa
Gennady
G
Kleinman
Guy
G
Katz
Haya
H
Hauzer
David
D
Bukelman
Amir
A
D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications / Q000175:diagnosis*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000601:surgery*