http://www.evrs.eu/medias/2006/congress/Cataract-Surgery-and-Vitrectomy-for-Proliferative-Vitreoretinopathy:-Comparisons-Between-Internal-Tamponades-and-Lens-Removal-Techniques.swf

Marcio B. Nehemy, MD, PhD (Belo Horizonte, Brazil), Erika P. Magalhães, MD, PhD (Belo Horizonte, Brazil), Patricia G. Nehemy, MD (Belo Horizonte, Brazil)

PURPOSE:

To compare the results of combined surgery for proliferative vitreoretinopathy (PVR) using silicone oil (SO) or C3F8, and phacoemulsification (PE) or pars plana lensectomy (PPL).

METHODS:

Design: Retrospective Interventional Case Series. Sixty two eyes with grade C PVR submitted to combined surgery, with minimum follow up of 6 months, were evaluated. All eyes had undergone pars plana vitrectomy (PPV), cataract removal and intraocular lens implantation (IOL). Comparisons between internal tamponades and lens removal techniques were performed.

RESULTS:

The retina was reattached in 57 eyes (44 with one surgery, seven with 2 surgeries and five with 3 surgeries). Visual acuity of 5/200 or better was obtained in 43 eyes (77%). Capsular opacification occurred in 44 eyes (71%), iridolens sinechias in 22 eyes (35%), retina detachment in 17 eyes (27%), transitory ocular hypertension in 10 eyes (16%), silicone oil in anterior chamber in 6 of 42 eyes (14%), persistent ocular hypotony in four eyes (6%) and cornea edema in one eye (2%). There was no statistical difference between SO or C3F8 tamponade, and between PE or PPL.

CONCLUSION:

Combined PPV and cataract surgery allows an extensive vitrectomy at the vitreous base and has proved to be safe and effective. The maintenance of the lens capsule and IOL insertion decrease the risks of anterior segment complications and provide better vision quality. This study showed similar results with PE or PPL, and SO or C3F8, but in 14% of  silicone cases the oil came to the anterior chamber.