Combination procedure offers many advantages

The combination of sutureless coaxial microincision cataract surgery and 23-gauge vitrectomy confers many advantages, including less wound leakage, good anterior chamber stability, safety, decreased inflammation and faster rehabilitation after surgery, according to the authors of a study published recently in Retina: The Journal of Retinal and Vitreous Diseases.

For this retrospective review, researchers from Linköping University Hospital, Linköping, Sweden, and St Erik Eye Hospital, Stockholm, reviewed outcomes and findings in 50 patients (50 eyes) who underwent coaxial microincision cataract surgery and foldable IOL implantation, combined with 23- gauge vitrectomy for a variety of indications between January 2010 and March 2012. They reviewed the indications, intraoperative/ postoperative complications and outcomes.

Their data showed the following:

• No posterior capsule tears were seen during surgery.
• Retinal breaks were found intraoperatively in nine eyes (18%), which were then successfully treated with laser and/or cryotherapy.
• Corneal suture was done in six eyes (12%).
• Sclerotomy was sutured in two left and two right eyes (total: 8%).
• In one case, a 23-gauge vitrectomy was converted to a 20-gauge vitrectomy.

Mean postoperative intraocular pressures (IOP) were 16.7 mmHg, and hypotony, defined as an IOP > 9 mmHg) occurred in nine eyes (18%). Posterior iris synechiae were seen 2 weeks postoperatively, with an IOP of > 40 mmHg in one eye (2%), and was normalized after Nd:YAG laser iridotomy.

Fibrin reaction in the anterior chamber was seen in one eye (2%) on day 1 posteroperatively. Finally, posterior capsule opacification requiring Nd:YAG laser capsulotomy was seen in 11 eyes (22%) during follow up.

Further information on this study can be found by clicking here.