Comparison of the Recurrence of RRD in PPV Combined Cataract Surgery with PPV Alone, and Risk Factors in PPV Combined Cataract Surgery

PURPOSE: To compare the recurrence percentage and risk factors of recurrence in rhegmatogenous retinal detachment (RRD) after pars plana vitrectomy (PPV) by in two groups of patients according to combined cataract surgery. METHODS: The recurrence percentage of RRD and risk factors after PPV over 20 years, performed by a single surgeon from January 1997 to September 2016, were retrospectively evaluated by classification into two groups according to combined cataract surgery. The risk factors were the patients' factors (age and sex), duration of disease, preoperative visual analyses, posterior capsular tears (PCR) during cataract surgery, the tamponade used, retinal detachment ranges, macular status, number and position of retinal tears, proliferative vitreoretinopathy (PVR) grade, and vitreous opacity. A total of 158 cases were included in the study. RESULTS: The recurrence percentage of RRD was not associated with combined cataract surgery. In the combined cataract surgery group, PCR (p = 0.020), inferior retinal tears (p = 0.037), and PVR above grade B (p = 0.037) were associated with the recurrence of RRD using univariate logistic regression analyses, but PCR (odds ratio 1.880, p = 0.021) was the only significant risk factor for RRD using multivariate logistic regression analyses. CONCLUSIONS: Cataract surgery can be performed at any time, but there should be consideration of the recurrence of RRD if there was PCR during combined cataract surgery.

Comparative Study of Combined Cataract Surgery in Primary Angle-Closure Glaucoma

Trabeculectomy, as an operation precedure for glaucoman, decrease intraocular pressure(IOP)effectively. But the amount of decrease in IOP is different according to the etiology of glaucoma. Thirty four primary angle-closure glaucoma patients (37 eyes)who had undergone trabeculectomy only or trabeculecomy combined with cataract surgery and had been subsequently followed up for least 6 months, were enrolled in this study. In 12 patients(14 eyes) among 16 patients (18 eyes, Group 1) who had undergone trabeculecto-my only, IOP was controlled without glaucoma medication, while glaucoma medication was needed in the other 4 patients (4 eyes). Among 18 patients (19 eyes, Group 2) who had undergone trabeculectomy combined with cataract surgery, IOP were controlled without glaucoma medication 9 patients (10 eyes); controlled with medication in 8 patients (8 eyes); and not controlled even with 1 patient (1 eye). The amount of decrease in IOP was no statistically different between the two groups. Group 2 had deeper anterior chamber than Group 1 (p<0.01). The above results suggest that the combined pro-cedure may benefit in primary angle-closure glaucoma patients, especially old complicated patients.

Incidence of ptosis following trabeculectomy: a comparative study

The occurrence of ptosis after trabeculectomy has been a common postoperative complication. Many factors have been implicated in the development of postoperative ptosis. The purpose of this study was to investigate the incidence of ptosis following trabeculectomy and whether or not it was influenced by combined cataract surgery, type of conjunctival flap, and previous intraocular surgery. We reviewed 386 eyes of 386 patients who underwent either trabeculectomy alone or trabeculectomy combined with cataract surgery, with greater than 6 month follow-up. Ptosis occurred in 10.7% (18 of 150 eyes) after trabeculectomy alone and in 12.7% (30 of 236 eyes) after trabeculectomy with combined cataract surgery (p = 0.96). The incidence of ptosis was 12.3% (10 of 81 eyes) after limbus-based conjunctival flap and 12.5% (38 of 305 eyes) after fornix-based conjunctival flap (p = 0.98). There was no significant difference in the incidence of ptosis between primary surgery eyes (12.5%, 34 of 273 eyes) and secondary surgery eyes (12.4%, 14 of 113 eyes) (p = 0.97). The incidence of ptosis after trabeculectomy was about 12% overall and not significantly influenced by combined cataract surgery, type of conjunctival flap or previous ocular surgery.