Pars Plana Posterior Capsulectomy during Phacovitrectomy

Soo Jin Lee; Yu Cheol Kim

doi:10.3341/jkos.2019.60.2.152

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Lee and Kim: Pars Plana Posterior Capsulectomy during Phacovitrectomy

Original Article

Journal of the Korean Ophthalmological Society 2019; 60(2): 152-159.

Published online: 15 February 2019

DOI: https://doi.org/10.3341/jkos.2019.60.2.152

Pars Plana Posterior Capsulectomy during Phacovitrectomy

Soo Jin Lee, MD, Yu Cheol Kim, MD, PhD

Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea.

Address reprint requests to Yu Cheol Kim, MD, PhD. Department of Ophthalmology, Keimyung University Dongsan Medical Center, #56 Dalseong-ro, Jung-gu, Daegu 41931, Korea. Tel: 82-53-250-7702, Fax: 82-53-250-7705, eyedoctor@dsmc.or.kr

Received 11 October 2018 Revised 23 October 2018 Accepted 24 January 2019

The Korean Ophthalmological Society

(open-access):

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 efficacy and safety of pars plana posterior capsulectomy (PPPC) during phacovitrectomy.

Methods

In this retrospective study, 76 patients (76 eyes) who underwent phacovitrectomy were enrolled. The patients were divided into two groups according to whether PPPC was performed during phacovitrectomy. In group A, PPPC using a vitreous cutter was combined with phacovitrectomy; in group B, only phacovitrectomy was performed. The best-corrected visual acuity (BCVA), predicted and actual refractive errors, adverse events, and posterior capsular opacity (PCO) were analyzed and compared between the two groups.

Results

Age, sex, and pre- and postoperative BCVA were not significantly different between group A (n = 37) and group B (n = 39). No intraoperative complications were identified in either group. In group A, the actual refraction (postoperative 2 months) was −0.44 ± 0.88 diopters (D) and a mild hyperopic shift was found compared to the preoperative predicted refraction (−0.56 ± 0.40 D). In group B, the actual refraction was −0.70 ± 0.72 D and a mild myopic shift was found compared to the preoperative predicted refraction (−0.60 ± 0.81 D). The difference in refraction shifts between the two groups was not significant but very close to it (p = 0.050). In group A, yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was not required. However, PCO was observed in 10 eyes in group B, 6 of which subsequently underwent YAG laser posterior capsulotomy at the last follow-up. Lens instability such as dislocation or subluxations was not observed during the follow-up period.

Conclusions

PPPC combined with phacovitrectomy may lead to hyperopic refractive changes. However, this was a safe and effective approach to prevent PCO and additional YAG laser posterior capsulotomy.

Keywords: Capsule opacification, Phacoemulsification, Vitrectomy

Figures and Tables

Figure 1

Slit lamp photographs of postoperative follow-up in each group. (A) Clear posterior capsulectomy margin (black arrowhead) two days after phacovitrectomy with pars plana posterior capsulectomy (group A). (B) Posterior capsule after yttrium-aluminum-garne laser capsulotomy at 12 months after combined vitrectomy and cataract surgery without posterior capsulectomy (group B). White arrows indicate lens epithelial cells on growth.

Table 1

Baseline characteristics of the patients in the two groups

Values are presented as mean ± standard deviation unless otherwise indicated.

OD =oculus dexter; OS = oculus sinister; preop = preoperative; BCVA = best corrected visual acuity; logMAR = logarithm of the minimum angle of resolution; postop = postoperative.

^*The p-values were calculated using independent t-test; ^†The p-values were calculated using Chi-square test.

Table 2

Postoperative diagnosis of the patients in the two groups

Values are presented as number (%).

Postop = postoperative; ERM = epiretinal membrane; PDR = proliferative diabetic retinopathy; M-hole = macular hole; VMT = vitreomacular traction; RRD = rhegmatogenous retinal detachment; BRVO = branch retinal vein occlusion; MA = macroaneurysm; AMD = age-related macular degeneration.

Table 3

Comparison of predicted postoperative refraction and actual postoperative refraction in group A and B at 2 months after operation

Values are presented as mean ± standard deviation.

Preop = preoperative; postop = postoperative.

^*The p-values were calculated using independent t-test; ^†The p-values were calculated using paired t-test.

Notes

This study was made possible with the 2018 SAMSUNG Eye Hospital Grant.

^{Conflicts of Interest} The authors have no conflicts to disclose.

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