PCO rates may be lower for smaller-gauge phacovitrectomy
Ophthalmic Surg Lasers Imaging. 2011;42(3):229-233.
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Risk of posterior capsule opacification after 23-gauge phacovitrectomy may be lower than that reported for 20-gauge phacovitrectomy. In addition, using short-acting gas tamponade and avoiding postoperative posturing may further lower the risk, a study suggested.
Smaller-gauge vitrectomy is less traumatic (no conjunctival peritomy, smaller instruments and no scleral sutures) and therefore causes less postoperative inflammation. Postoperative intraocular inflammation is linked to PCO development, the study authors said.
Univariate analysis with chi-square tests and multivariate analysis with logistic regression were used to assess data on 221 consecutive patients of a single surgeon in the retrospective analysis. All patients had minimum follow-up of at least 6 months.
PCO developed in 20.8% of patients, with 12.7% of patients developing the complication within 3 months. According to the study authors, rates of PCO after 20-gauge phacovitrectomy ranged between 17.9% and 51.1% in past studies.
Multiple logistic regression analysis determined that the two most significant factors linked to PCO development were postoperative posturing (relative risk = 4.1, P < .001) and use of longer-acting gas tamponade (relative risk = 2.8, P = .01). Notably, most patients who needed posturing were positioned face-down.
Compared with other surgical indications, rhegmatogenous retinal detachment had the highest rate (33.3%) of postop PCO. An axial length of more than 24.5 mm and intraoperative/postoperative complications were also major risk factors. Complications occurred in 14.6% of patients, with elevated IOP being the most popular, and increased the risk of PCO by 3.3 times.