title: Macular hole surgery and cataract extraction: combined vs consecutive surgery.
abstract: OBJECTIVE
  To compare the functional and the anatomic outcomes of a combined surgery and consecutive surgery for macular hole and cataract extraction.
  
  
  METHODS
  Multicenter, retrospective, comparative case series.
  
  
  METHODS
  One hundred twenty patients (120 eyes) with an idiopathic macular hole and cataract were operated on in 1 or 2 sessions in 2 academic centers, Dijon University Hospital and Nancy University Hospital. Combined surgery (n = 64) and consecutive surgery (n = 56) were performed between 2006 and 2007. All patients underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. Cataract extraction was performed with phacoemulsification followed by a posterior chamber intraocular lens implantation. The main outcome measures were near and far visual acuity at 6 and 12 months, and the rate of closure of macular hole evaluated with optical coherence tomography.
  
  
  RESULTS
  After a 12-month follow-up, the postoperative best-corrected visual acuities significantly improved in both the combined and the consecutive surgery groups (near and far vision in both groups, P < .0001). However the improvement of far visual acuity was not significant in the consecutive surgery group at 6 months (P = .06) while such an improvement was observed in the combined surgery group (P < .0001). The rates of closure, 100% and 96% in the combined and the consecutive groups respectively, and the complications did not differ significantly between groups.
  
  
  CONCLUSIONS
  Both combined and consecutive surgeries are safe and effective methods to treat macular hole and cataract with equivalent functional and anatomic results in both procedures. However, combined surgery shortened the delay for visual recovery.
authors.affiliation: Department of Ophthalmology University Hospital, Rue du Faubourg Raines, Dijon, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Muselier
authors.forename: Brice
authors.initials: B
authors.lastname: Dugas
authors.forename: Xavier
authors.initials: X
authors.lastname: Burelle
authors.forename: Marie
authors.initials: M
authors.lastname: Passemard
authors.forename: Isabelle
authors.initials: I
authors.lastname: Hubert
authors.forename: Bénigne
authors.initials: B
authors.lastname: Mathieu
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Berrod
authors.forename: Alain M
authors.initials: AM
authors.lastname: Bron
authors.forename: Catherine
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications*; D017679:Cryotherapy; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D012167:Retinal Perforations / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C048381:perfluoroethane; C042852:perflutren; D013459:Sulfur Hexafluoride