Combined extra capsular cataract extraction and pars plana vitrectomy
Purpose. Pars plana vitrectomy is the standard operative procedure for many vitreoretinal diseases. When the condition is associated with a cataract, the surgeon may decide to perform cataract extraction at the same time as the vitrectomy. The purpose of this paper is to review results and complications of this combined procedure. Methods. We retrospectively studied the records of 16 patients, treated between January 1981 and December 1991, who had undergone extracapsular cataract extraction together with pars plana vitrectomy in one operation. Data collected included: age, sex, best corrected vision, presence of diabetes mellitus, vitreoretinal pathology, previous history of pan-retinal photocoagulation and the status of the other eye. Results. Nine patients were diabetics. Indication for vitrectomy included: vitreous hemorrhage (13 cases) and severe asteroid hyalosis (3 cases). Three patients received preoperative laser photocoagulation and five patients received supplemental endophotocoagulation during the surgery. Vitrectomy followed cataract extraction in 12 cases and in four cases, it was performed before the cataract extraction. Posterior chamber intraocular lenses were implanted in 14 cases and two cases were left without implant. In one case no implant was used due to a severe traumatic cataract with loss of capsular support. In the other case, there was a cyclitic membrane behind the capsule and since the capsule was opaque, it was removed as well. Final visual acuity improved in nine cases, remained the same in three cases and deteriorated in four cases. Conclusion. The improvement in visual acuity is due to clearing of the vitreous hemorrhage and removal of the cataractous lens. We believe the persistence of poor vision or the deterioration of vision is due to the preexisting vitreoretinal pathology. The alternative for these patients would be blindness.
Woodward, J; Ruiz, RS; El-Harazi, SM; Kellaway, J
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