Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology

Demetriades, Anna M.; Gottsch, John D.; Thomsen, Robert W.; Azab, Amr; Stark, Walter J.; Campochiaro, Peter A.; Juan, Eugene de; Haller, Julia A.

doi:10.1016/s0002-9394(02)01972-4

Cited by 152 publications

(117 citation statements)

References 14 publications

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“…Furthermore, cataract surgery in a vitrectomised eye can be challenging with fluctuating anterior chamber, weak zonules, and unstable posterior capsular support. 7 Hence, there has been an increasing trend towards combining cataract surgery with immediate sequential PPPV for a variety of indications such as macular holes, retinal detachment, and proliferative diabetic retinopathy. [7][8][9] A combined PPPV is considered a safe approach with faster rehabilitation, which prevents the need for a second operation for a postvitrectomy cataract.…”

Section: Discussionmentioning

confidence: 99%

“…7 Hence, there has been an increasing trend towards combining cataract surgery with immediate sequential PPPV for a variety of indications such as macular holes, retinal detachment, and proliferative diabetic retinopathy. [7][8][9] A combined PPPV is considered a safe approach with faster rehabilitation, which prevents the need for a second operation for a postvitrectomy cataract. The fact that vitrectomy is increasingly small gauge, sutureless, and hence quicker is also contributing to the popularity of combined phacovitrectomy.…”

Section: Discussionmentioning

confidence: 99%

“…This is significantly less than the rates reported by many of the other studies, especially where phacoemulsification was combined with 20-G vitrectomy. 7 A reason for this may be that there are less chances of a raised IOP in sutureless tranconjunctival vitrectomy, with the cornea more likely to retain clarity due to less intraoperative trauma and less IOP spikes. Krishnan et al 11 have shown that postoperative IOP is significantly higher after 20-G phacovitrectomy compared with 23-G PPPV at day 1 and just below significance at day 7.…”

Section: Discussionmentioning

confidence: 99%

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Microincision cataract surgery combined with vitrectomy: a case series

Jalil

Steeples

Subramani

et al. 2014

Eye

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Microincision cataract surgery combined with vitrectomy: a case series

Jalil

Steeples

Subramani

et al. 2014

Eye

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“…Thus, combined phacovitrectomy is an effective and safe procedure to handle both cataract and vitreoretinal diseases. [1][2][3] However, corneal contour is significantly changed causing postoperative astigmatism by 20-gauge vitrectomy. [4][5][6] Recently, 23-gauge microincisional vitrectomy surgery (MIVS) had less surgically induced astigmatism (SIA) compared with 20-gauge vitrectomy.…”

Section: Introductionmentioning

confidence: 99%

Combined 23-gauge microincisonal vitrectomy surgery and phacoemulsification with AcrySof toric intraocular lens implantation: a comparative study

Park

Shin

Kim

2011

Eye

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Aim To compare AcrySof toric intraocular lens (IOL) and non-toric IOL in patients who had combined 23-gauge microincisional vitrectomy surgery (MIVS) and phacoemulsification for vitreoretinal diseases and cataract with pre-existing corneal astigmatism. Methods This is a prospective comparative study comprised of 30 patients (30 eyes) who had combined 23-gauge MIVS and phacoemulsification for vitreoretinal diseases and cataract with pre-existing regular corneal astigmatism greater than 1 diopters (D). In all, 15 eyes had AcrySof toric IOL (Alcon Laboratories) and 15 eyes had non-toric IOL (Akreos AO MI60; Bausch & Lomb) implantation. Main outcome measures were uncorrected visual acuity (UCVA), refractive cylinder, surgically induced astigmatism (SIA), and IOL misalignment during 6 months. Results The mean UCVA of the toric IOL group was better than the non-toric IOL group at postoperative months 1, 3, and 6 (Po0.001, respectively). The mean absolute residual refractive cylinder of the toric IOL group at postoperative week 1, and months 1, 3, and 6 was less than the non-toric IOL group (P ¼ 0.008, o0.001, o0.001, and o0.001, respectively). There was no difference in the mean SIA between the two groups (P40.05, respectively). The mean toric IOL axis rotation was 3.52±2.751, which was within 51 in 66.7% of the toric IOL group and within 101 in 100%.Conclusions Combined 23-gauge MIVS and phacoemulsification with AcrySof toric IOL implantation is an effective method of correcting vitreoretinal diseases and cataract and pre-existing corneal astigmatism, and the toric IOL showed good rotational stability, even in vitrectomized eyes for 6 months.

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“…Consequently, combined vitreo-retinal and cataract surgery has been established during the 1980s and 1990s and is under discussion up to date. [2][3][4] One of the aforementioned technical developments is the employment of smallcaliber instruments first described by Fujii et al 5 in 2002. For the first approximately three decades, ppv was usually performed with 20-gauge instruments that were inserted into the vitreous via a sclerotomy through the pars plana; 6 the resulting scleral cut typically requires surgical sealing with sutures.…”

Section: Introductionmentioning

confidence: 99%

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

2013

Eye

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Background/aims 23-gauge pars plana vitrectomy (ppv) is a new method for vitreoretinal surgery. It may reduce operation time, the risk of complications, and patient discomfort, especially in combination with simultaneous bimanual microincisional cataract surgery (b-MICS). Methods Seventy-five consecutive patients who underwent combined cataract surgery and ppv at our center between 1 January 2008 and 31 December 2010 were included. The first 36 patients were treated with 20-gauge ppv, the following 39 patients with 23-gauge ppv. Study end points 8 weeks after surgery were duration of the procedure, improvement of visual acuity, and occurrence of complications. Results Duration of surgery was reduced in 23-vs 20-gauge ppv (54.0 ± 11.6 vs 61.0 ± 19.0 min, P ¼ 0.08). Visual acuity improved significantly in both the groups (20-gauge: logMAR 0.750±0.304 before and 0.369±0.273 after surgery; 23-gauge: logMAR 0.663±0.340 before and 0.339±0.273 after surgery). There were no appreciable group differences in baseline or post-treatment visual acuity. Conclusions 23-gauge ppv in combination with b-MICS is a suitable, safe, and effective method for the treatment of combined cataract and vitreo-retinal diseases. The procedure is somewhat shorter and patient discomfort during and after surgery is improved. In terms of efficacy and safety, 23-gauge ppv is equivalent with conventional 20-gauge ppv.

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Combined phacoemulsification, intraocular lens implantation, and vitrectomy for eyes with coexisting cataract and vitreoretinal pathology

Cited by 152 publications

References 14 publications

Microincision cataract surgery combined with vitrectomy: a case series

Microincision cataract surgery combined with vitrectomy: a case series

Combined 23-gauge microincisonal vitrectomy surgery and phacoemulsification with AcrySof toric intraocular lens implantation: a comparative study

23- vs 20-gauge pars plana vitrectomy in combination with bimanual microincisional cataract surgery (b-MICS) for the treatment of macular hole and cataract as a one-step procedure

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