Combined phacoemulsification and sutureless 23-gauge pars plana vitrectomy for complex vitreoretinal diseases.
BACKGROUND
To evaluate the safety and visual outcomes of combined phacoemulsification and sutureless 23-gauge vitrectomy for concomitant cataract and vitreoretinal diseases.


METHODS
Retrospective consecutive interventional case series. 114 eyes of 111 patients underwent combined sutureless 23-gauge vitrectomy and phacoemulsification surgery between 1 January 2006 and 1 March 2009. Main outcome measures were visual acuity and perioperative complications.


RESULTS
All patients had at least 3 months follow-up (mean 263 days). The main vitreoretinal surgical indications were intractable cystoid macular oedema, epiretinal membrane and retinal detachment. Mean logMAR visual acuity improved from baseline 20/192 to 20/129 at 3 months (p=0.005). Mean intraocular pressure (IOP) increased from baseline 15.8 mm Hg to 17.7 mm Hg (p=0.033) on postoperative day 1 and then decreased by postoperative month 3 to 14.8 mm Hg (p=0.019). 110 (96.5%) eyes had significant pre-existing macular disease, and 93 (81.6%) received preoperative treatments. 82 (71.9%) patients required supplemental treatment(s) at a mean of 91.5 days, most commonly intravitreal injections to reduce vascular leakage or YAG capsulotomy. Hypotony, defined as IOP <5, was observed in four (3.5%) patients, and no patient developed endophthalmitis. Capsular tears were more frequent in eyes with a history of previous radiation or vitrectomy.


CONCLUSIONS
Combined phacoemulsification and sutureless 23-gauge vitrectomy surgery was safely and effectively used for cataracts and a variety of complex vitreoretinal diseases.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th St, Miami, FL 33136, USA.
Robert A
RA
Sisk
Timothy G
TG
Murray
D002386:Cataract / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods*; D012164:Retinal Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*