Comparison of Posterior Capsular Opacification between a Combined Procedure and a Sequential Procedure of Pars Plana Vitrectomy and Cataract Surgery

Abstract

Purpose: To compare posterior capsular opacification (PCO) between a combined procedure and a sequential procedure of pars plana vitrectomy (PPV) and cataract surgery (CS). Methods: The medical records of 89 eyes of 85 patients who underwent PPV and CS were retrospectively reviewed. There were 56 eyes of 52 patients with a combined PPV and CS (the combined surgery group), and 33 eyes of 33 patients with CS in a previously vitrectomized eye (the sequential surgery group). The control group was comprised of 130 eyes of 102 patients who underwent CS alone. All patients were followed up for at least 1 year after CS. The major outcome measures were the PCO rate and the interval between CS and PCO formation. There were no significant differences in age and the incidence of diabetes among the 3 groups. Results: The PCO rate checked at 1 year after CS was 12.5% (7/56) in the combined surgery group, 24.2% (8/33) in the sequential surgery group, and 4.6% (6/130) in the control group. The differences in the PCO rate between the subgroups as well as among the 3 groups were statistically significant (p < 0.05). There were no significant differences in the interval between CS and PCO formation among the 3 groups. Conclusion: This study demonstrates that the PCO rate may be lower in patients who have a combined procedure of PPV and CS than in those who have a sequential procedure.

Efficacy of combined 25-gauge microincision vitrectomy, intraocular lens implantation, and posterior capsulotomy

“…2,11 Posterior capsule opacification is also reported to occur more frequently after phacovitrectomy (12.5%) than after phacoemulsification and IOL implantation alone (4.6%). 12 Our study also supports existing data showing that posterior capsulotomy is a practical method for preventing postoperative PCO in patients with vitreoretinal disease who require a phacovitrectomy. 10 However, our study also found that posterior capsulotomy did not prevent PCO in every case.…”

Nd:YAG Capsulotomy after Phacoemulsification in Vitrectomized Eyes: Effects of Pars Plana Vitrectomy on Posterior Capsule Opacification

“…Rahman et al assumed that this discrepancy was due to the effect of posterior vitreous pressure on PCO. Furthermore, sequential cataract surgery after vitrectomy has been shown to lead to a higher incidence of PCO than combined surgery [18]. In our study, Nd:YAG capsulotomy free survival times showed no difference in both surgical option groups by both statistical comparison and survival plot.…”

“…As age and diabetes may be related to the rate of PCO after phacovitrectomy or cataract surgery only [17, 29], these intergroup differences may have introduced bias into our study. However, the use of age matching reduced the potential influence of this bias and age and diabetes were not identified as risk factors, which has also been noted in a previous study [18]. Furthermore, we retrospectively evaluated the surgical outcomes during longer period, so evolution of surgical techniques and surgical instruments, especially intraocular lenses, could be potential bias of this study.…”

“…Further, when cataract surgery is combined with PPV, either sequentially or simultaneously, PCO is also the most common factor threatening vision [12]. In previous reports, the rate of PCO after phacovitrectomy has ranged from 10.3% to 51.1% and from 8% to 51% in sequential surgery [12–18]. Particularly, in eyes with vitreoretinal disease, postvitrectromy PCO interferes with the ability to diagnose retinal pathology.…”

Posterior capsule opacification following 20- and 23-gauge phacovitrectomy (posterior capsule opacification following phacovitrectomy)

“…There have been a few reports regarding the development of PCO following phacovitrectomy. 3,4,6,14 However, those studies included several kinds of disease and used various procedures, including gas tamponade, indicating that those results could be affected by selection bias. Thus, in this report, the same three procedures were performed for each ERM case; cataract surgery, core vitrectomy, and ERM peeling.…”