A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery

Soliman, Mohamed Kamel; Hardin, Johanna; Jawed, Fayez; Uwaydat, Sami H.; Faramawi, Mohammed F.; Chu, Colin J; Yang, Ya-Ting; Sallam, Ahmed

doi:10.1016/j.ophtha.2018.05.027

Cited by 34 publications

(49 citation statements)

References 34 publications

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“…D UE TO THE CONTINUOUS ADVANCES IN INSTRUmentation and surgical technique, the indications of pars plana vitrectomy (PPV) have expanded and have become a common surgical procedure for various vitreoretinal disorders, such as retinal detachment, macular hole, macular pucker, proliferative diabetic retinopathy, and vitreous hemorrhage. 1,2 One of the wellknown sequela of vitrectomy is the cataract formation or acceleration, [3][4][5] with up to 80% within 2 years. 2,[6][7][8] Studies have suggested that light toxicity, oxidation of lens proteins, use of intraocular gas or silicone oil, length of surgery, mechanical trauma, and increased postoperative oxygen tension within the eye may be causative factors of cataract after PPV.…”

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confidence: 99%

Accuracy of New Generation Intraocular Lens Calculation Formulas in Vitrectomized Eyes

Tan

Zhang

et al. 2020

American Journal of Ophthalmology

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PURPOSE: To compare the prediction accuracy of new intraocular lens (IOL) calculation formulas (Barrett Universal II [BUII], Emmetropia Verifying Optical [EVO], Kane and Ladas Super formula) and traditional formulas (Haigis, Hoffer Q, Holladay 1, and SRK/T) with Wang-Koch (WK) axial length (AL) adjustment in vitrectomized eyes.DESIGN: Retrospective consecutive case-series study. METHODS: One hundred eleven eyes of 111 patients underwent uneventful phacoemulsification and enVista MX60 implantation after vitrectomy were enrolled and divided into 4 groups according to whether the vitreous cavity was filled with silicone oil. The performance of each formula was evaluated with or without lens constant optimization.RESULTS: Before lens constants optimization, the mean prediction errors (MEs) of all formulas were statistically different from zero (0.14-0.46 diopters [D]) in vitrectomized eyes, except for the Kane formula. The BUII, EVO, Kane, and Haigis had relatively lower mean absolute error (MAE) and median absolute error (MedAE) with optimized constants. No significant systemic bias was found in new formulas for vitrectomized eyes with AL >26 mm (P > .05). The Hoffer Q and Holladay 1 displayed significantly hyperopic shift (0.39 and 0.51 D) for long eyes, which was corrected by the WK adjustment. There were no significant differences in the prediction accuracy of all formulas among 4 subgroups (P > .05).CONCLUSIONS: The BUII, EVO, Kane, and Haigis displayed comparable performance in vitrectomized eyes with optimized constants. In vitrectomized highly myopic eyes, the new formulas and traditional formulas with WK adjustment exhibited satisfactory prediction accuracy. Silicone oil tamponade did not affect the prediction accuracy of formulas using IOLMaster 700.

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confidence: 99%

Accuracy of New Generation Intraocular Lens Calculation Formulas in Vitrectomized Eyes

Tan

Zhang

et al. 2020

American Journal of Ophthalmology

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“…In these patients, anterior chamber fluctuations and deep anterior chamber increased mobility in the posterior lens, and zonular instability can be observed during cataract surgery due to the lack of vitreous support. During a vitrectomy, direct zonules or lens damage may develop, and the reactive effect of tamponade on zonules may cause zonular weakness (14). Any of these conditions may increase the risk of preoperative complications during cataract surgery.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of axial length changes after combined phacovitrectomy for macula-off rhegmatogenous retinal detachment

Özal¹

2019

Beyoglu Eye J

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To evaluate the reliability of optical biometry for correct intraocular lens (IOL) power calculation in eyes with macula-off rhegmatogenous retinal detachment (RRD) via comparing the axial lengths (AL) measured with optical biometry preoperatively and postoperatively. Methods: This retrospective study was conducted with 25 eyes of 25 patients who underwent combined surgery (phacoemulsification and pars plana vitrectomy (PPV)) with the diagnosis of RRD with macular involvement. Best-corrected visual acuity (BCVA), biomicroscopic examination, intraocular pressure measurement and full fundoscopic examination were performed in all patients. Axial length was measured using optical biometry in all patients. The AL measurements were repeated in the postoperative third month in the patients using gas tamponade during vitreoretinal surgery and in the third month after the silicone oil removal in patients using silicone-oil tamponade during vitreoretinal surgery. Results: The mean age of the patients was 61.60±7.33. Fifteen patients (60%) were female, and 10 (40%) were male. Postoperative BCVA values (0.40±0.28) were significantly higher than the preoperative BCVA values (0.14±0.22) (p<0.05). The preoperative mean value of AL was measured as 24.66±1.90 and the postoperative mean value of AL was 24.67±1.91. There was no statistically significant difference between the measured AL values in the preoperative and postoperative periods (p=0.258). Conclusion:Combined surgery (phacoemulsification and PPV) is a frequently applied method in RRD treatment. The correct AL measurement is important for the removal of refractive errors due to AL measurement in patients with macula-off RRD. Optical biometry provides accurate results in these cases.

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“…Cataract is the most common complication of pars plana vitrectomy (PPV) used extensively to treat various posterior segment pathologies [1,2]. Phacoemulsification cataract surgery is associated with more complications in an eye after PPV compared with nonvitrectomized eyes [3][4][5][6]. e prevalence of posterior capsule rupture (PCR) in nonvitrectomized eyes is 1.92 to 3.5% [7].…”

Section: Introductionmentioning

confidence: 99%

“…e prevalence of posterior capsule rupture (PCR) in nonvitrectomized eyes is 1.92 to 3.5% [7]. In contrast, the reported rates of PCR in vitrectomized eyes were up to 13.3%, accompanied with a higher rate of zonular dialysis, dropped nuclear fragments, and choroidal exudation [3,4,6,8,9]. e situation is relevant to anatomical changes of a vitrectomized eye that shows reduced vitreous gel support, possibly with defective zonular apparatus, and an impaired or fibrotic lens capsule [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Insufficient vitreous cavity support also contributes to the disparity between the anterior and posterior pressures during fluid filling by phacoemulsification and aspiration (I/A), inducing an excessively fluctuating lens-iris diaphragm [3,[10][11][12]. ese conditions may deteriorate preexisting zonular or capsular deficiency in vitrectomized eyes and trigger surgical complications [3,4,6,10,13]. us, fluid management between anterior and posterior segments is essential for maintaining vitreous cavity support to ensure positive cataract surgeries after PPV.…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative Posterior Chamber Irrigation to Enhance Vitreous Cavity Support during Phacoemulsification Cataract Surgery after Vitrectomy

Lyu

Zhao

2020

Journal of Ophthalmology

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is properly cited.Purpose. To report the effectiveness of an intraoperative posterior chamber irrigation technique to enhance vitreous cavity support during postvitrectomy phacoemulsification cataract surgery. Methods. e irrigation technique was performed during phacoemulsification cataract surgery on 10 postvitrectomy eyes (9 patients) with moderate or hard density cataracts and with low vitreous cavity support. A cohesive viscoelastic tamponade was applied to pressurize the anterior chamber to start the procedure. e vitreous cavity was then irrigated using a 26-gauge flushing cannula injecting balanced salt solution under the iris through the zonules, until the vitreous cavity pressure balanced and exceeded the anterior chamber pressure and viscoelastic flowed out from the corneal incision. Intraoperative performance with the irrigation technique, postoperative visual acuity, and anatomy, and complications were retrospectively evaluated. Results. e irrigation procedure instantly enhanced posterior segment pressure before capsulorhexis in 4 eyes, before phacoemulsification in 4 eyes, after phacoemulsification in 2 eyes, before intraocular lens implantation in 6 eyes, and after implantation in 3 eyes. Phacoemulsification cataract surgery was facilitated by the irrigation technique, with a stabilized anterior chamber and robust vitreous cavity support. No complications occurred intraoperatively and postoperatively. At a 3-month follow-up, favorable visual and anatomic outcomes were achieved in all eyes. Conclusions. e irrigation technique balanced the pressure of anterior and posterior segments. us, vitreous cavity support and anterior chamber depth were well stabilized during phacoemulsification cataract surgery in postvitrectomy eyes.

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A Database Study of Visual Outcomes and Intraoperative Complications of Postvitrectomy Cataract Surgery

Cited by 34 publications

References 34 publications

Accuracy of New Generation Intraocular Lens Calculation Formulas in Vitrectomized Eyes

Accuracy of New Generation Intraocular Lens Calculation Formulas in Vitrectomized Eyes

Evaluation of axial length changes after combined phacovitrectomy for macula-off rhegmatogenous retinal detachment

Intraoperative Posterior Chamber Irrigation to Enhance Vitreous Cavity Support during Phacoemulsification Cataract Surgery after Vitrectomy

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