Combined phacoemulsification, pars plana vitrectomy, and posterior chamber intraocular lens insertion
S. B. Koenig, W. F. Mieler, D. P. Han and G. W. Abrams
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee.
Eighteen eyes with coexisting cataract and vitreoretinal disease underwent
combined phacoemulsification, pars plana vitrectomy, and posterior chamber
lens implantation. Preoperative vitreoretinal disease included nonclearing
vitreous hemorrhage (eight eyes), vitreous hemorrhage and tractional
retinal detachment (three eyes), tractional retinal detachment (one eye),
epiretinal membranes (three eyes), peripheral uveitis (two eyes), and a
retained intraocular metallic foreign body (one eye). Postoperative visual
acuity improved in each case; 14 eyes achieved visual acuity between 20/20
and 20/80 during an average postoperative period of 11 months (range, 3 to
39 months). Perioperative complications included an iatrogenic retinal
break (one eye) and pupillary block glaucoma (one eye). Four eyes required
YAG laser capsulotomy postoperatively. Phacoemulsification did not
interfere with corneal clarity, allowed water-tight wound closure during
vitrectomy, and preserved the capsular bag, allowing endocapsular fixation
of the posterior chamber lens. Combining phacoemulsification, posterior
chamber lens implantation, and pars plana vitrectomy allows rapid visual
rehabilitation and functional unaided vision in these eyes.
