Morphologic changes in the anterior segment after phacovitrectomy for proliferative diabetic retinopathy.
OBJECTIVE
To determine whether combined phacoemulsification and intraocular lens implantation with pars plana vitrectomy (PPV) (phacovitrectomy) in patients with proliferative diabetic retinopathy (PDR) causes morphologic changes in the anterior segment and to evaluate whether there is a relationship between the anatomic changes and inflammatory complications.


METHODS
Department of Ophthalmology, Chonnam National University Hospital, Gwangju, South Korea.


METHODS
Patients who had uneventful surgery for PDR were divided into 2 groups (phacovitrectomy and PPV only). Morphologic changes in the ciliary regions were measured by ultrasound biomicroscopy (UBM) 1 day before surgery and 1, 2, 3, 5 days, 2 weeks, 1 and 2 months after surgery. The UBM parameters and inflammatory complications in the 2 groups were compared.


RESULTS
The study comprised 60 patients; 30 had phacovitrectomy and 30, PPV only. The frequency of supraciliary effusions was higher in the phacovitrectomy group (24/30, 80%) than in the PPV-only group (14/30, 46%) (P = .015). The decrease in angle opening and anterior chamber depth was more prominent after phacovitrectomy. The incidence of complications was higher in the phacovitrectomy group than in the PPV-only group (60% versus 30%, abnormal intraocular pressure; 30% versus 7%, intraocular fibrin and posterior synechia formation); the complications were associated with supraciliary effusions.


CONCLUSIONS
The results indicate that phacovitrectomy for PDR may induce more morphologic changes in the anterior segment. Supraciliary effusions were associated with inflammatory complications. Appropriate control of postsurgical inflammation is necessary in phacovitrectomy for PDR.
Park
Sung Pyo
SP
Department of Ophthalmology, Hallym University Medical School, Seoul, Korea.
Ahn
Jae Kyoun
JK
Lee
Gwang Hoon
GH
D000328:Adult; D000368:Aged; D002924:Ciliary Body / Q000000981:diagnostic imaging / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D014603:Uveal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D014821:Vitrectomy / Q000009:adverse effects*