Microincision Cataract Surgery Combined With Vitrectomy

A Case Series

A Jalil, L Steeples; S Subramani, MS Bindra; F Dhawahir-Scala; N Patton

Disclosures

Eye. 2014;28(4):386-389. 

In This Article

Abstract and Introduction

Abstract

Aim: The objective of this study was to present the results of combined phacovitrectomy using 1.8 mm microincision cataract surgery (MICS) with special emphasis on the anterior segment complications in this group.

Methods: Retrospective, single-centre case series involving consecutive patients undergoing phacovitrectomy in a single centre in the United Kingdom during a 6-month period.

Results: A total of 52 eyes underwent combined MICS and pars plana vitrectomy. Intraoperative complications included posterior capsule rupture (n=2), minor iris trauma during phacoemulsification (n=1), iatrogenic retinal tears (n=2), and entry site break (n=1). Postoperatively two cases had significant inflammation, one of which resulted in 360° posterior synaechiea, iris bombe, and raised intraocular pressure. Other complications included mild posterior synaechiae (n=2), posterior capsular opacification (n=3), cystoid macular oedema (n=1), and hyphaema (n=1), which spontaneously resolved. There were no cases of intraocular lens decentration. Two patients who underwent surgery for retinal detachment repair subsequently redetached. Among those having surgery for macular hole, non-closure was seen in one patient and one patient developed a retinal detachment.

Conclusion: In conclusion, sub-2 mm MICS is a safe and effective technique in dealing with vitreoretinal disorders necessitating cataract surgery at the same time.

Introduction

Both cataract and vitreoretinal surgery are evolving towards ever-smaller incisions. In retinal surgery, transconjunctival 'sutureless' pars plana vitrectomy with 23-, 25-, and 27-G techniques have been described.[1–3] Likewise, microincision cataract surgery (MICS) can be achieved by sub-2 mm incisions.[4] The main advantages of MICS include minimising surgically induced astigmatism and reducing higher-order corneal aberrations.[5] When performing a combined phacovitrectomy (sequential phacoemulsification/intraocular lens (IOL) insertion followed by pars plana vitrectomy; PPPV), a smaller corneal wound size may have additional advantages to the subsequent vitrectomy, including avoiding the need for wound suturing and preventing the anterior chamber from collapsing during the subsequent PPPV. We present a consecutive case series of patients undergoing combined phacovitrectomy using 1.8 mm (microincision) corneal wounds with special emphasis on anterior segment complications of the procedure.

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