Aims To evaluate the incidence of and factors contributing to intraoperative and postoperative complications of eyes with previous pars plana vitrectomy (PPV) undergoing phacoemulsification and intraocular lens (IOL) implantation for cataract.

Methods The intraoperative and postoperative complications and observations in 513 eyes of 485 patients with previous PPV undergoing sutured and sutureless cataract surgery were assessed. Associations between preoperative characteristics and complications during and after the surgery were explored.

Results The median interval from PPV to cataract surgery was 15.7±19.5 months. The mean follow-up period was 35.1±31.4 months. Intraoperative complications and observations were: posterior capsular plaque in 50 eyes (9.7%), posterior capsule rupture in 28 eyes (5.5%), loss of nuclear material into vitreous in 17 eyes (3.3%), and zonular dialysis in 12 eyes (2.3%). The most common postoperative complication was posterior capsular opacification (PCO) in 171 eyes (33.3%). PCO correlated with duration of PPV (p<0.001), younger age (p=0.003), and shorter interval from PPV to cataract surgery (p=0.01). Higher rates of postoperative IOL decentration and dislocation correlated with male sex, 20-gauge PPV, 20-gauge PPV with scleral buckling surgery (p<0.001), and longer interval from PPV to silicone oil extraction (p=0.006). Endophthalmitis was not observed in either the sutured or sutureless groups of patients.

Conclusions Longer duration of PPV surgery, a longer interval from PPV to silicone oil extraction, prior 20-gauge PPV, and 20-gauge PPV with scleral buckling surgery seem to influence the safety and outcomes of cataract surgery. Sutureless phacoemulsification in vitrectomised eyes was not associated with a higher incidence of endophthalmitis, suprachoroidal effusion or haemorrhage.