Combination of cataract surgery, vitrectomy requires different criteria in IOL power selection

ROME — Vitrectomy performed at the same time as cataract surgery often induces a myopic shift that needs to be taken into account when choosing the IOL to be implanted, according to a study.

At the Rudolf Foundation Clinic in Vienna, Austria, 40 patients with cataract complicated by the presence of epiretinal membrane or macular hole were operated with phacoemulsification and simultaneous vitrectomy. Forty patients with cataract only were used as controls. Different types of IOLs were randomly implanted in the two groups.

"Multivariate regression analysis showed a significantly different IOL power prediction error between the study group and the control group. Patients in the study group had induced myopia of approximately –0.4 D," Christiane I. Falkner-Radler, MD, said at the winter meeting of the European Society of Cataract and Refractive Surgeons. "This myopic shift was greater in patients who had epiretinal membrane surgery than in those who had macular hole surgery."

No statistically significant difference in the IOL power prediction error was found between single-piece or three-piece IOLs.

"We recommend the use of a slightly hyperopic IOL in patients having combined surgery," Dr. Falkner-Radler said.