Mechanized Posterior Capsulectomy During Combined Vitrectomy and Cataract Surgery

Su Eun Park; Sung Jin Lee

doi:10.3341/jkos.2007.48.10.1335

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Park and Lee: Mechanized Posterior Capsulectomy During Combined Vitrectomy and Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2007;48(10):1335-1340.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.10.1335

Mechanized Posterior Capsulectomy During Combined Vitrectomy and Cataract Surgery

Su Eun Park, M.D., Sung Jin Lee, M.D.

Department of Ophthalmology, College of Medicine Soonchunhyang University, Seoul, Korea

Address reprint requests to Sung Jin Lee, M.D., Department of Ophthalmology, College of Medicine, Soonchunhyang University, #657 Hannam-dong, Yongsan-gu, Seoul 140-743, Korea, Tel: 82-2-709-9354, Fax: 82-2-798-7797, E-mail: wismNe@unitel.co.kr

Received 20 March 2007 Accepted 13 June 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To analyze the effects and the stability of a posterior capsulectomy during combined vitrectomy and cataract surgeries in patients with retinal disease.

Methods

Between 2003 and 2005, the records of patients who underwent posterior capsulectomy during a combined vitrectomy and cataract surgery were followed for 12 months. Among 26 total eyes (17 were from males and nine from females), the average age was 63. An epiretinal membrane was found in 18 eyes, branch retinal vein occlusion in three eyes, diabetic macular edema and vitreous opacity in two eyes, and a macular hole in one eye. The posterior capsulotomy was made smaller than the optic using a vitrectomy cutter after insertion of a posterior chamber intraocular lens (IOL). We investigated postoperative visual acuity, inflammation, and complications.

Results

There were no intraoperative complications. One month postoperatively, one eye (3.8%) showed an increase in intraocular pressure of more than 30 mmHg, one eye (3.8%) showed 2+ inflammatory cells in the anterior chamber. Visual acuity increased by 2 lines postoperatively in 13 eyes (50.0%), whereas visual acuity decreased by more than 1 line in one eye (3.8%). There was a slight deceleration of IOL within 1 mm in two eyes (7.7%) and there was no reclosure of the posterior capsulectomy one year postoperatively.

Conclusions

Posterior capsulectomy during combined vitrectomy and cataract surgery in patients with retinal disease was simple, safe, and effective in preventing after cataract.

Keywords: Cataract surgery, Mechanized, Posterior capsulectomy, Retinal disease, Vitrectomy

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Figure 1.

Anterior segment photograph shows anterior (linear arrow) and posterior capsulotomy lines (dotted arrow) at 1 day postoperatively. The posterior capsulotomy was done during combined vitrectomy and cataract operation.

Figure 2.

Anterior segment photograph shows mild marginal opacity of the anterior and posterior capsules but clear central view 1 year after posterior capsulotomy during combined vitrectomy and cataract operation.

Figure 3.

LogMAR visual acuity results (n=26).

Table 1.

Patients summary

Case	Age	Sex	Retinal diseases^*	ILM peeling	Gas^† tamponade	IOL^‡	Complications 1 mo postop^§	Compliations 1 yr postop
1	58	M	ERM^*	-	-	S	-	-
2	62	F	ERM	-	-	S	decent	decent
3	64	F	ERM	-	-	C	-	-
4	63	M	ERM	-	-	C	-	-
5	71	M	ERM	-	-	C	-	-
6	63	M	ERM	-	-	C	-	-
7	69	M	ERM	-	-	C	-	-
8	63	F	ERM	-	-	C	-	-
9	63	M	ERM	-	-	C	-	-
10	61	M	ERM	+	-	S	-	-
11	58	M	ERM	+	-	S	-	-
12	59	F	ERM	+	+	S	Decent	Decent
13	59	F	ERM	+	+	S	-	-
14	63	M	ERM	+	-	C	-	-
15	62	M	ERM	+	-	S	-	-
16	64	F	ERM	+	-	C	Inflam	-
17	63	M	ERM	+	-	C	-	-
18	68	M	ERM	-	-	C	-	-
19	61	M	BRVO	-	-	S	-	-
20	62	M	BRVO	-	-	S	-	-
21	70	F	BRVO	-	-	C	-	-
22	59	M	DME	+	+	S	IIOP	-
23	67	F	DME	+	-	C	-	-
24	60	M	Vitreous Opacity	-	+	S	-	-
25	66	F	Vitreous Opacity	-	-	C	-	-
26	58	M	Macular Hole	+	+	S	-	-

^∗ ERM: Epiretinal membrane, BRVO: Branch retinal vein occlusion, DME: Diabetic macular edema,

^† Gas tampon: SF₆ or C₃F₈ gas tamponade,

^‡ IOL: intraocular lens, C: Centerflex, S: Sensar

^§ Decent: decenteration, Inflam: inflammation, IIOP: increased intraocular pressure.

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