Comparison of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy for patients with cataract and vitreoretinal diseases.
OBJECTIVE
To compare effectiveness and outcomes of clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy and standard 20-gauge vitrectomy system for patients with clinically significant cataract and vitreoretinal diseases.


METHODS
Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.


METHODS
Clear corneal phacoemulsification combined with 25-gauge transconjunctival sutureless vitrectomy was performed in the study group (15 eyes). Patients in the control group (15 eyes) had combined surgery with clear corneal phacoemulsification and the existing 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure, and intraoperative and postoperative complications. The additional outcome measurements in both groups were duration of the surgical procedures, time to return to preoperative corneal clarity, time to achieve stable vision, and subjective ocular irritation postoperatively.


RESULTS
Postoperatively, BCVA improved in 12 eyes (80%) in the study group and in 11 eyes (73.3%) in the control group. Mean operative time for opening and closing the sclerotomy was significantly greater in the control group than in the study group. Time to return to preoperative corneal clarity and time to achieve stable vision showed no significant difference between the groups. Compared with the control group, postoperative ocular irritation in patients in the study group was considerably reduced.


CONCLUSIONS
Combined sutureless surgery needed shorter setup time for sclerotomy and caused less postoperative ocular irritation than combined surgery with 20-gauge vitrectomy. Therefore, this type of procedure would be a good option for selected cases with cataract and vitreoretinal diseases.
Chang
Cheng-Jong
CJ
Department of Ophthalmology, Tri-Service General Hospital, Taipei 114, Taiwan, Republic of China. retina@ms14.hinet.net
Chang
Yun-Hsiang
YH
Chiang
Shang-Yi
SY
Lin
Le-Tien
LT
D000368:Aged; D002386:Cataract / Q000150:complications*; D003315:Cornea / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D012164:Retinal Diseases / Q000150:complications* / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000150:complications* / Q000601:surgery