Combined vitrectomy/phaco not suitable for all

Combined vitrectomy and phacoemulsification with foldable intraocular lens (IOL) implantation is safe but should only be recommended in selected patients, according to study results published online ahead of print by Acta Ophthalmologica.

Wensheng Li of Wenzhou Medical College, Zhejiang, China and colleagues conducted a retrospective study to measure the incidence of adverse events and postoperative visual acuity (VA) of eyes (n=186) with visually significant cataracts and a variety of vitreoretinal complaints (most commonly, non-diabetic vitreous haemorrhage and proliferative diabetic retinopathy), in whom phaco and foldable IOL implantation was combined with vitroretinal surgery.

Vision ranged from 0.6 to light perception preoperatively, and 1.2 to no light perception postoperatively. VA improved by ≥3 lines, remained within three lines and decreased in 87.1%, 7.5% and 5.3% of eyes, respectively (n=162, 14 and 10, respectively). Adverse events included corneal and macular oedema, recurrent retinal detachment, elevated intraocular pressure (IOP), persistent macular hole and rubeosis iridis.

Thus the researchers concluded that, although the combined procedure is both effective and safe, it should be limited to eyes with simultaneous cataract and changes to the pathology of their vitreoretinal status.