gms | German Medical Science

PPV surgeries are often combined with cataract surgery. Since the exact positioning of toric lenses is a delicate matter to good visual outcome, simultaneous as well as temporal closely adjacent PPV surgery represents an additional factor to be considered in functional outcome of toric lens implantation. The current study was conducted in order to evaluate the impact of a PPV on the alteration of toric lens positioning in simultaneous and subsequent cataract surgery in comparison to solely implantation of toric lenses.

Setting/venue: Breyer Kaymak Augenchirurgie, Dusseldorf/Germany, Augenambulanz Marienhospital, Dusseldorf/Germany

Methods: In our retrospective study we analyzed the functional outcome of three different populations: simultaneous (A) as well as sequential (B) combined surgeries in comparison to implantation of a toric lens only (C). Populations comprised 6 eyes (A), 8 eyes (B) and 40 eyes (C). Analysis included visual acuity via ETDRS chart, subjective refraction and wave front analysis (KR1-W™, Topcon).

Results: Postoperative cylindric outcome was –0.50 ± 0.27 (A) vs. –0.75 ± 0.50 (B) vs. –0.34 ± 0.39 (C) Diopters. Best corrected visual acuity (BCVA) increased from 0.50 ± 0.33 to 0.80 ± 0.18 (A) vs. from 0.36 ± 0.17 to 0.76 ± 0.21 (B) vs. from 0.53 ± 0.22 to 0.97 ± 0.12 (C) in decimal visus. Wave front analysis showed in general a low extent of aberrations with no visible differences between the two combinatorial methods.

Conclusion: Functional outcome after a combination of astigmatism correcting cataract surgery and pars plana vitrectomy is well in accordance with cataract surgery only. In both combined surgery procedures we observed a stable lens positioning. Rotation, if occured, was not detectable with the applied methods. Thus we conclude, that additional PPV does not interfere with lens positioning given that the surgery is performed carefully. Future studies have to prove our results by inceased sample sizes. Additional measurement of lens tilt via Purkinjemeter allows a more fine tuned analysis of the procedures and could underline an earlier trend.

Financial disclosure: We, the authors, declare, that we do not have a financial interest of the outcome of the current study. Dr. Kaymak, Dr. Klabe and Dr. Breyer are further consultants to the following companies: Alcon, AMO, CZM, Domilens, Fluoron, Geuder, Oculentis, Oertli, Rayner Surgical, RVO, Topcon.