Jae Kyoun Ahn, Gwang Hoon Lee (Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea)

Purpose:

To evaluate the morphologic effect of cataract surgery combined with pars plana vitrectomy (PPV) for retinal vascular diseases on anterior segments.

Methods:

We prospectively recruited fifty-two patients who underwent uncomplicated PPV for retinal vascular disease (42 with proliferative diabetic retinopathy and 10 with branch

retinal vein occlusion) and divided the patients into two groups according to the cataract surgery in addition to PPV. The morphologic changes of the anterior segments were measured by ultrasound biomicroscopy (UBM) one day before and one day, two days, three days, five days, two weeks, one month, and 2 months after the surgery. The main outcome measures were the thickness and area of the ciliary body, the frequency of supraciliary effusions, angle opening, and anterior chamber depth. We compared the UBM parameters between the two groups.

Results:

The mean thickness and area of the ciliary body were similar between the two groups during the postoperative 2 months. The frequency of supraciliary effusion was significantly higher in the combined surgery group (17/21, 81%) than in the PPV only group (14/31, 45%). The angle opening and anterior chamber depth were significantly decreased in the patients who had supraciliary effusion during early postoperative periods. All these changes returned to preoperative status at postoperative 2 weeks. The occurrence rate of posterior synechiae was higher in the combined surgery group (8/21, 37%) than in the PPV only group (2/31, 7%).

Conclusions:

Our results indicate that the cataract surgery combined with PPV for retinal vascular diseases may cause more inflammatory morphologic changes of ciliary body than PPV without cataract surgery. We believe that adequate control of postoperative inflammation may be required in cases who receive the cataract surgery combined with PPV.