Combined Clear Corneal Phacoemulsification and Vitrectomy Versus Two-Step Surgery in Korean Patients With Idiopathic Epiretinal Membrane

Kyoung In Jung; Min Hye Song; Young Jung Roh

doi:10.3341/jkos.2011.52.2.203

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Jung, Song, and Roh: Combined Clear Corneal Phacoemulsification and Vitrectomy Versus Two-Step Surgery in Korean Patients With Idiopathic Epiretinal Membrane

Original Article

J Korean Ophthalmol Soc 2011;52(2):203-209.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.2.203

Combined Clear Corneal Phacoemulsification and Vitrectomy Versus Two-Step Surgery in Korean Patients With Idiopathic Epiretinal Membrane

Kyoung In Jung, MD, Min Hye Song, MD, Young Jung Roh, MD

Department of Ophthalmology and Visual Science, The Catholic University of Korea School of Medicine, Seoul, Korea

Address reprint requests to Young Jung Roh, MD Department of Ophthalmology, Yeouido St. Mary's Hospital, The Catholic University of Korea #62 Yeouido-dong, Yeongdeungpo-gu, Seoul 150-713, Korea Tel: 82-2-3779-1848, Fax: 82-2-761-6869, E-mail: youngjungroh@hanmail.net

Received 18 January 20103 September 2010 Accepted 25 November 2010

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 evaluate the surgical outcomes on the combined procedures of phacoemulsification, intraocular lens (IOL) implantation, and vitrectomy, and to compare clinical results with sequential surgery results in Korean patients with idiopathic epiretinal membrane.

Methods

The present retrospective study included 20 eyes of 19 patients with idiopathic epiretinal membrane who underwent combined phacoemulsification, IOL implantation, and pars plana vitrectomy (combined surgery), and 18 eyes of 18 patients who underwent phacoemulsification and IOL implantation subsequent to vitrectomy (sequential surgery). Postoperative clinical results and intra- and postoperative complications were compared between the 2 groups.

Results

Postoperative best corrected visual acuity (BCVA) (logMAR) was 0.41 ± 0.42 in the combined group, and 0.35 ±0.37 in the sequential group. There was no significant difference in BCVA between the 2 groups (p = 0.675). The mean refractive prediction error was −0.46 ± 0.88 diopters (D) in the combined group, and −0.06 ± 0.68 D in the sequential group, showing no statistically significant difference between the 2 groups (p = 0.147). The present study showed no major differences between the 2 groups in complications such as intraoperative mild corneal edema, postoperative ocular hypertension, and lens capsular opacity.

Conclusions

Combined phacoemulsification, IOL implantation, and pars plana vitrectomy as well as the two-step procedure are safe and effective for treating patients with idiopathic epiretinal membrane.

Keywords: Idiopathic epiretinal membrane, Intraocular lens implantation, Pars plana vitrectomy, Phacoemulsification

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Figure 1.

Distribution of the interval between vitrectomy and subsequent phacoemulsification in sequential group.

Table 1.

Summary of preoperative characteristics and outcomes in the two study groups: combined surgery and sequential surgery

		Combined surgery (n = 20)	Sequential surgery (n = 18)	p-value
Preoperative characteristics	Proportion of males	8 (40.0%)	3 (16.6%)	0.113
	Proportion of right eye	8 (40.0%)	8 (44.4%)	0.782
	Age (yr, Mean ± SD^∗)	66.8 ± 6.9	64.6 ± 7.3	0.184
	Mean preop BCVA^† (logMAR, mean ± SD)	0.60 ± 0.17	0.61 ± 0.22	0.867
	Mean preop IOP^‡ (mmHg, mean ± SD)	14.35 ± 3.08	14.22 ± 3.82	0.910
	Refractive astigmatism (diopters, mean ± SD)	0.84 ± 0.76	0.77 ± 0.69	0.860
	With-the-rule/against-the-rule astigmatism (number)	7/9	7/8	0.870
	Follow up duration (mon, mean ± SD)	15.20 ± 2.98	16.16 ± 4.12	0.425
Postoperative outcomes	Mean BCVA^† (logMAR, mean ± SD)	0.44 ± 0.18	0.35 ± 0.37	0.675
	Mean IOP^‡ (mmHg, mean ± SD)	14.15 ± 4.12	14.11 ± 3.34	0.975
	Mean refractive prediction error (diopters, mean ± SD)	-0.46 ± 0.88	-0.06 ± 0.68	0.147
	Postoperative refractive astigmatism (diopters, mean ± SD)	0.89 ± 0.74	0.79 ± 0.56	0.643
	Change in astigmatism after surgery (diopters, mean ± SD)	0.20 ± 0.56	0.01 ± 0.69	0.385
	IOL^§ (diopters, mean ± SD)	21.28 ± 2.70	19.80 ± 1.61	0.063

^∗ SD = standard deviation;

^† BCVA = best corrected visual acuity;

^‡ IOP = intraocular pressure;

^§ IOL = intraocular lens.

Table 2.

Comparison of late postoperative (fro surgery and sequential surgery om 1 week to 1 year after surgery) compli cations of the two study groups: combined

	Combined surgery (n =20)	Sequential surgery (n = 18)
Posteior capsular opacification	4 (20%)	2 (11.1%)
IOL^∗ dislocation	0	0
Rubeosis iridis	0	0
Persistent ERM^†	0	0
Ocular hypertension	1 (5%)	0
Retinal detachment	1 (5%)	0
Vitreous hemorrhage	0	0
Hypotony	0	0
Endophthalmitis	0	0

^∗ IOL = intraocular lens;

^† ERM = epiretinal mem brane.

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