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Phaco after vitrectomy yields higher posterior capsule rupture rate than combined surgery
A higher rate of posterior capsule rupture was found in eyes that underwent cataract surgery after previous vitrectomy than in eyes that underwent combined cataract surgery and vitrectomy, according to a study.
“These results may be caused by a hard nucleus cataract in a vitrectomized eye,” the study authors said. “Proposed solutions to these problems could be either to perform cataract surgery combined with vitrectomy or right after vitrectomy or to use the advanced modifications of the phaco chop technique.”
The retrospective study included 365 eyes of 365 patients who underwent pars plana vitrectomy and phacoemulsification with IOL implantation; 311 eyes underwent concurrent vitrectomy and cataract surgery (combined surgery group), and 54 previously vitrectomized eyes underwent cataract surgery (sequential surgery group).
A control group comprised 334 eyes of 334 patients who underwent cataract surgery alone.
Mean patient age was 54.57 years in the combined surgery group, 55.76 years in the sequential surgery group and 60.87 years in the control group.
Cataract surgery preceded vitrectomy in the combined surgery group. The mean interval between vitrectomy and cataract surgery in the sequential surgery group was 9.19 months.
Posterior capsule rupture occurred in six eyes (11.4%) in the sequential surgery group and 14 eyes (4.5%) in the combined surgery group; the between-group difference was statistically significant (P = .049).
Preoperative cataract density was significantly higher in the sequential surgery group than in the other groups (P < .001).
Visual acuity improved significantly in all three groups, the authors said.