Article
Pars-plana vitrectomy, phakoemulsification, and intraocular lens implantation: Comparison of clinical complications in a combined versus two-step surgical approach
Search Medline for
Authors
Published: | September 22, 2004 |
---|
Outline
Text
Objective
To determine anterior segment complications after pars-plana vitrectomy, phaco-emulsification and intraocular lens implantation. A comparison of combined versus sequential surgery and the underlying vitreoretinal pathology is given
Methods
Frequency and spectrum of complications in 114 eyes with combined surgery and 26 eyes with sequential surgery were retrospectively analysed. Postoperative follow-up time was between 3 and 12 months.
Results
Combined surgery: 65 eyes (57.0%) showed no complications. 18 eyes (15.8%) showed a transient intraocular pressure rise and 17 eyes (14.9%) a fibrin reaction in the anterior chamber. Posterior synechia occurred in 7 eyes (6.1%), posterior capsule tears in 5 eyes (4.4%). IOL dislocation or opacificating macrophages on the IOL-surface were seen in 3 eyes (2.6%) each. Rare complications included silicon oil prolaps into the anterior chamber (1.8%), anterior chamber hemorrhage (1,8%) and iris incarceration into the corneoscleral incision (0,9%). 2 eyes (1,8%) needed IOL-Explantation during the follow-up. Subgroup analysis showed transient pressure elevation in cases with gas tamponade. Sequential surgery: 23 eyes (88.5%) showed no complications. Posterior capsule tears occurred in 2 cases (7.7%). Posterior synechia and dislocation of the IOL were seen in 1 eye (3.8%) each.
Conclusions
Combined pars-plana vitrectomy, phacoemulsification and intraocular lens implantation as well as sequential surgery exhibit only rare severe complications. In this study the complication rate seems to be lower in the two-step procedure. Long-term observations will follow.