Postoperative Outcomes of Combined Phacovitrectomy for Epiretinal Membrane With a Concurrent Cataract vs Standalone Phacoemulsification for a Cataract

Abstract

Purpose: To compare the postoperative outcomes after combined phacovitrectomy for epiretinal membrane and cataract (combined group) vs standalone phacoemulsification (control group). Methods: A systematic literature search of Ovid MEDLINE, CINAHL, and the Cochrane Library was performed. The primary outcomes were the refractive predictive error and mean absolute error expressed as the spherical equivalent. Secondary outcomes were the best-corrected visual acuity (BCVA). The weighted mean prediction error was calculated, and the mean absolute error outcomes were combined for a meta-analysis. When a meta-analysis was not feasible, a narrative synthesis was performed. Results: Of 3632 articles identified in the database search, 6 retrospective case control studies and 1 prospective case study met the inclusion criteria. The 7 studies comprised a total of 584 eyes (combined group, 278 eyes; control group, 306 eyes). The combined weighted mean (±SD) prediction error was -0.41 ± 0.85 D in the combined group, showing a myopic shift, and 0.09 ± 0.45 D in the control group. The meta-analysis for the postoperative mean absolute error showed a significant difference between groups (mean deviation, 0.10; 95% CI, 0.02-0.17; P = .01), favoring the control group. The mean BCVA was 0.34 ± 0.21 logMAR in the combined group and 0.575 ± 0.23 logMAR in the control group (Snellen equivalent, 6/12 and 6/19, respectively). Conclusions: The results of the meta-analysis showed that phacovitrectomy for ERM and concurrent cataract leads to higher prediction errors than standalone phacoemulsification for cataract. However, the postoperative BCVA was comparable between the 2 procedures.

Keywords: epiretinal membrane; pars plana vitrectomy; phacoemulsification; phacovitrectomy; refractive predictive error.

Figure 1.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart of study search strategy.

Figure 2.

Forest plot of the mean absolute error, comparing combined phacovitrectomy with IOL implantation for epiretinal membrane vs concurrent cataract and phacoemulsification alone. Abbreviation: IV, independent variable.