Efficiency of phacoemulsification of primary cataract by the second stage after vitreoretinal surgery of PDR patients.

Author: Karina Igorevna Konovalova (Russian Federation)

Co-authors: Mikhail Mikhailovich Shishkin, Rinat Rustamovich Fayzrakhmanov

Purpose

Evaluation the efficacy of phacoemulsification of primary cataract by the second stage after vitreoretinal surgery of PDR patients.

Setting/Venue

National Medical and Surgical Center named after N.I.Pirogov of the Ministry of Healthcare of the Russian Federation.

Methods

67 cases of surgery treatment of patients with PDR and complicated primary cataract were enrolled. This patients were divided into two groups depending on the treatment tactics. In the 1st group patients were subjected to a two–step surgical procedure: vitreoretinal surgery with silicone oil tamponade performed as the 1st step in their treatment; followed by the 2d step, phacoemulsification surgery and silicone oil removal, and the IOL implantation, respectively. In the 2d group phacoemulsification performed simultaneously with vitreoretinal surgery: phacoemulsification, IOL implantation, vitreoretinal surgery with silicone oil tamponade. The second step included the removal of silicone oil from the vitreous cavity.

Results

Visual functions improved in 88.6% of cases in group 1, and in 68.7% in group 2. Frequency of postoperative complications: the severity of inflammatory reactions on the 2nd day after the 1st step surgery was significantly higher in patients of group II. The development of neovascular glaucoma was significantly more frequent in patients of group II (n=9; 28,1%) than in patients of group I (n=3; 8,6%), p=0.037.

Conlusions

Outcomes of the preliminary studies suggest that it is more viable to perform phacoemulsification surgery sometime later along with silicone oil removal on PDR patients with complicated primary cataract. This sequence of treatment procedure ensures a more gentle approach to the anatomic structures of the eye during the first stage (vitreoretinal surgery) and contributes to the reduction in the number of intraoperative and postoperative complications.

Financial Disclosure

No author has a financial or property interest in any material or method mentioned

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