Phacoemulsification in vitrectomised eyes / 国际眼科杂志(Guoji Yanke Zazhi)

ABSTRACT

Purpose To report our experience of phacoemulsification in patients who had previously undergone parsplana vitrectomysurgery. Methods Medical records of 26 consecutive cases of phacoemulsification operated on between July 1994 and July 1998, who hadpreviously undergone parsplana vitrectomy, were retrospectively analysed. Patient demographics, the initial indication and number ofparsplana surgeries, type of cataract and preoperative visual acuity were noted for all patients. The intraoperative, early, and latepostoperative complications were analysed. The final visual acuity and its correlation to the preoperative potential acuity meter (PAM)visual acuity were analysed. Results Outof26, 24 were males and 2 were females, ranging in age from19 to 63 years. 18patients(69.2%) had undergone parsplana vitrectomy once, 7 (26.9%) twice and (3.8%) three times. Proliferative diabetic retinopathy (38.5%) andretinal detachment (23.7%) were the common indications for parsplana vitrectomy. Posterior subcapsular cataract was the predominanttype seen in 13 patients (50%). Intraoperative complications included small pupil in 4 (15.5%), posterior capsular break in 1 (3.8%), poorvisibility in 2 (7.7%), posterior capsular plaques in 2 (7.7%), and excessive deep anterior chamber in 2 (7.7%). The notable earlypostoperative complication was corneal edema existing at one week in 13 patients (50%) which cleared in all cases by the 4th week.Posterior capsular opacification was seen in 5 cases (19%). 9 patients had a final visual acuity of ≤ 20/100 and in 8 of these patients,significant retinal or optic nerve pathology was noted. In 13 patients, the final best corrected visual acuity was equal to or better than PAMacuity whereas in 2 cases, the best corrected visual acuity was less than the PAM acuity. Conclusions Phacoemulsification is a safe andeffective surgical procedure in post-vitrectomised eyes. Posterior subcapsular cataract is the predominant type of cataract seen in thisseries. Small pupils, posterior capsular plaques which can not be polished and excessive deep anterior chambers are commonintraoperative complications. Corneal edema and posterior capsular opacification are significant postoperative complications. Preexistingretinal or optic nerve pathology determin the final visual acuity and potential acuity meter can correctly predicts the final visual acuity inmost patients.