title: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the results and complications of combined 23-gauge sutureless vitrectomy, clear corneal phacoemulsification, and intraocular lens implantation in patients with proliferative diabetic retinopathy.
  
  
  METHODS
  This was a retrospective, consecutive, noncomparative, interventional case series of 136 eyes of 108 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the complications of proliferative diabetic retinopathy. The main outcome measures were visual outcomes and surgical complications.
  
  
  RESULTS
  Main indications for the combined surgery were vitreous hemorrhage (78 eyes, 57.4%) and tractional retinal detachment (36 eyes, 28.7%). The logarithm of the minimum angle of resolution visual acuity (mean ± SD) improved from 0.86 ± 0.59 preoperatively to 0.39 ± 0.52 six months postoperatively (P < 0.0001). Intraoperative retinal tear occurred in 7 eyes (5.1%) and postoperative vitreous hemorrhage in 10 eyes (7.5%). Even in the absence of suturing of sclerotomy sites, only 1 eye (0.7%) had postoperative hypotony (<6 mmHg). During the 6 months after surgery, only 1 eye (0.7%) developed neovascular glaucoma and 6 eyes (4.4%) required a repeat vitrectomy (3 for retinal detachment and 3 for vitreous hemorrhage).
  
  
  CONCLUSIONS
  Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy was safe and effective. It may have not only the known advantages of conventional combined surgery but also additionally those such as faster visual rehabilitation and less conjunctival fibrosis.
authors.affiliation: Department of Ophthalmology, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Dae Yeong
authors.initials: DY
authors.lastname: Lee
authors.forename: Hoon Seok
authors.initials: HS
authors.lastname: Jeong
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Sohn
authors.forename: Dong Heun
authors.initials: DH
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications*; D003315:Cornea / Q000601:surgery; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000601:surgery*; D055815:Young Adult