Journal List > J Korean Ophthalmol Soc > v.48(10) > 1007937

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

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.

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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.
jkos-48-1335f1.tif
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.
jkos-48-1335f2.tif
Figure 3.
LogMAR visual acuity results (n=26).
jkos-48-1335f3.tif
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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