Outcome and Complications of Combined Phacoemulsification and 23-Gauge Pars Plana Vitrectomy

Abstract

Background: With the advances in surgical tools, simultaneous removal of cataract associated with vitreoretinal disorders is gaining popularity. This combined surgery offers several advantages besides limitations. The aim of this study is to assess the outcome and complications of phacoemulsification combined with pars plana vitrectomy (PPV).

Patients and methods: In this retrospective review, medical charts of patients undergoing phacovitrectomy for coexisting cataract and various vitreoretinal disorders were analyzed. Patient demographics, retinal diagnosis, visual acuities (VA) in logMAR, intraocular pressure (IOP), intraoperative and postoperative complications were assessed. Clear corneal phacoemulsification and 23-gauge transconjunctival PPV were administered in all cases.

Results: Eighty-four eyes of 64 (76.2%) males and 20 (23.8%) females were enrolled. The average age of patients was 59.5 ± 13.8 (18-81). The average period of follow-up was 7.2 ± 7.5 months (1-36). The vitreoretinal diagnoses were as follows: 28 (33.3%) rhegmatogenous retinal detachment, 23 (27.4%) vitreous hemorrhage, 12 (14.3%) intraocular foreign body, 12 (14.3%) epiretinal membrane, 4 (4.8%) macular hole, 4 (4.8%) tractional retinal detachment, and 1 (1.2%) vitreomacular traction. The most common intraoperative complications were miosis and rupture of the posterior capsule (92.9% and 8.3%, respectively). In 8 (9.5%) cases, there was fibrin in the anterior chamber. Posterior synechia developed in 7 (8.3%) of cases. No severe increase in intraocular pressure was evident.

Conclusion: Phacoemulsification combined with PPV is a safe and efficient way of management in cases where cataract coexists with vitreoretinal pathologies.