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3 - Surgical results of 23G pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation
Dilek Güven, Mehmet Demir, Erdem Ergen, Yekta Sendul, Atakhan Yıldız, Sönmez Cınar
Objective: To present the surgical results of pars plana vitrectomy and phacoemulsification (phacovitrectomy) plus intraocular lens (IOL) implantation in eyes with vitreoretinal pathology
Material and Method: This retrospective study included 91 eyes of 80 (44 female/36 male) consecutive patients undergoing phacovitrectomy plus IOL implantation during a 3-year period. Baseline and last best corrected visual acuity (BCVA), retinal pathologies, presence of systemic disease, preoperative lens status, history of any therapeutic intervention prior to surgery, type of intravitreal tamponade used, need for additional intervention, complications and the latest ocular examination results were considered.
Results: Mean age was 64.8±9.5 years. Diabetes mellitus (DM), hypertension (HT), DM+HT and coronary artery disease (CAD) were the accompanying systemic diseases, observed in 74%, 56%, 45% and 18.7% of the patients, respectively. Indications for phacovitrectomy were macular surface disease in 52%, vitreus hemorrhage (VH) in 31%, tractional retinal detachment (TRD), diabetic retinopathy or proliferative vitreoretinopathy (PVR) in 11% and rhegmatogenous retinal detachment (RRD) in 5.5% of the eyes. Mean preoperative and postoperative BCVA were 0.10±0.14, 0.22±0.22, (p<0.001), respectively. BCVA increased in 61%, remained stable in 24% of the eyes. The most common anterior and posterior segment complications were related to IOL in 16.5% and VH in 11% eyes, respectively. At the last visit, retina was attached with functional macula in 63 eyes. Foveal atrophy, macular hole formation, optic atrophy, VH, phthisis and recurrent RD were the causes of decrease or loss of vision.
Conclusion: Phacovitrectomy with IOL implantation is a safe and effective surgery providing good visualization during vitrectomy and preventing a cataract operation in another session in such a patient group with serious systemic diseases.
Keywords: Posterior segment pathologies, phacoemulsification, cataract, vitrectomy
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