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Combined phacoemulsification and sutureless 23-gauge pars plana vitrectomy for complex vitreoretinal diseases
  1. Robert A Sisk1,2,
  2. Timothy G Murray1
  1. 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
  2. 2Cincinnati Eye Institute, Cincinnati, Ohio, USA
  1. Correspondence to Dr Timothy G Murray, Bascom Palmer Eye Institute, 900 NW 17th St, Miami, FL 33136, USA; tmurray{at}med.miami.edu

Abstract

Background To evaluate the safety and visual outcomes of combined phacoemulsification and sutureless 23-gauge vitrectomy for concomitant cataract and vitreoretinal diseases.

Methods Retrospective consecutive interventional case series. 114 eyes of 111 patients underwent combined sutureless 23-gauge vitrectomy and phacoemulsification surgery between 1 January 2006 and 1 March 2009. Main outcome measures were visual acuity and perioperative complications.

Results All patients had at least 3 months follow-up (mean 263 days). The main vitreoretinal surgical indications were intractable cystoid macular oedema, epiretinal membrane and retinal detachment. Mean logMAR visual acuity improved from baseline 20/192 to 20/129 at 3 months (p=0.005). Mean intraocular pressure (IOP) increased from baseline 15.8 mm Hg to 17.7 mm Hg (p=0.033) on postoperative day 1 and then decreased by postoperative month 3 to 14.8 mm Hg (p=0.019). 110 (96.5%) eyes had significant pre-existing macular disease, and 93 (81.6%) received preoperative treatments. 82 (71.9%) patients required supplemental treatment(s) at a mean of 91.5 days, most commonly intravitreal injections to reduce vascular leakage or YAG capsulotomy. Hypotony, defined as IOP <5, was observed in four (3.5%) patients, and no patient developed endophthalmitis. Capsular tears were more frequent in eyes with a history of previous radiation or vitrectomy.

Conclusions Combined phacoemulsification and sutureless 23-gauge vitrectomy surgery was safely and effectively used for cataracts and a variety of complex vitreoretinal diseases.

  • Lens and zonules
  • retina
  • surgery
  • treatment

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Footnotes

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Miami Internal Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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