Phacoemulsification and foldable intraocular lens implantation combined with 23-gauge transconjunctival sutureless vitrectomy
Received 26 October 2008; received in revised form 8 February 2009; accepted 10 February 2009.
Purpose
To evaluate the effectiveness, technical feasibility, outcomes, and complications of phacoemulsification and intraocular lens (IOL) implantation combined with 23-gauge transconjunctival sutureless vitrectomy.
Setting
Ophthalmology Department, Calderdale Royal Hospital, Halifax, United Kingdom.
Method
This retrospective noncomparative interventional case series evaluated the results of 23-gauge transconjunctival sutureless vitrectomy combined with phacoemulsification and IOL implantation. Primary outcome measures included suture, complication, and hypotony rates; logMAR visual acuity; and intraocular inflammation.
Results
Sixty consecutive patients (60 eyes) were included. The mean visual acuity was 0.87 logMAR ± 0.68 (SD) preoperatively and 0.46 ± 0.34 logMAR 6 weeks postoperatively; the improvement was statistically significant (P<.0001). The 23-gauge ports were self-sealing in all eyes but 4 (6.7%), in which a single pars plana port was sutured. The mean intraocular pressure was 24.0 ± 15.6 mm Hg 1 day postoperatively. Eight eyes (13.0%) had postoperative hypotony (<10 mm Hg); all recovered spontaneously within 24 hours. Of the eyes in which long-term tamponade was not necessary (n =12), all 3 with no endotamponade and 3 of 9 with air tamponade had postoperative hypotony; the difference was not statistically significant (P = .09).
Conclusions
Combined transconjunctival sutureless vitrectomy and phacoemulsification was effective and safe in managing simultaneous cataract and vitreoretinal pathology. The self-sealing incisions did not adversely affect the overall surgical or visual outcomes, led to faster visual rehabilitation, and reduced ocular inflammation. The use of air tamponade when no long-term endotamponade was necessary appeared to reduce the risk for hypotony.
From Calderdale Royal Hospital (Sood, Rahman), Salterhebble, West Yorkshire, and the Academic Unit of Ophthalmology (Dennison), University of Birmingham, Birmingham, United Kingdom
Corresponding author: Miss Vaneeta Sood, MRCOphth, Specialty Registrar Ophthalmology, Calderdale Royal Hospital, Salterhebble, West Yorkshire, HX3 0PW, United Kingdom.
No author has a financial or proprietary interest in any material or method mentioned.
Presented at the British and Eire Vitreoretinal Society Meeting, St. Andrews, Scotland, November 2007.
ABSTRACT