[Pars plana vitrectomy, phacoemulsification and intraocular lens implantation for the management of cataract and proliferative diabetic retinopathy: comparison of a combined versus two-step surgical approach]
| Autor: | P, Rivas-Aguiño, R A, García-Amaris, M H, Berrocal, J G, Sánchez, A, Rivas, J F, Arévalo |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Aged 80 and over Male Fibrin Diabetic Retinopathy Phacoemulsification Time Factors Vitreoretinopathy Proliferative Retinal Detachment Visual Acuity Exudates and Transudates Middle Aged Cataract Vitreous Hemorrhage Postoperative Complications Lens Implantation Intraocular Ischemia Vitrectomy Humans Female Macula Lutea Intraoperative Complications Aged Follow-Up Studies Retrospective Studies |
| Zdroj: | Archivos de la Sociedad Espanola de Oftalmologia. 84(1) |
| ISSN: | 1989-7286 |
| Popis: | To report the intra-and postoperative complications and visual acuity outcomes in pars plana vitrectomy (PPV), phacoemulsification and intraocular lens (IOL) implantation in patients with cataract and proliferative diabetic retinopathy (PDR). A comparison of the combined versus two-step surgical approach is given.Retrospective uncontrolled interventional clinical trial. Forty-eight eyes of 48 consecutive patients with PDR were included. Twenty-eight (58.3%) eyes with combined surgery and 20 (41.7%) eyes with sequential surgery were analyzed.Postoperative follow-up time was between 6 and 63 months (mean: 18 months). 1) Combined surgery: Preoperative best-corrected visual acuity (BCVA) ranged from 20/200 to hand motions, and postoperative BCVA ranged from 20/30 to hand motions. BCVA improved in 17 eyes (60.7%), while in 7 (25%) eyes there was no change (or =2 ETDRS lines) in VA, and in 4 (14.3%) eyes BCVA decreased. Postoperative complications included vitreous hemorrhage (VH) in 10 (35.7%) eyes, and fibrinous exudation in 9 (32.1%) eyes. 2) Two-step surgery: Preoperative BCVA ranged from 10/200 to light perception, and from 20/40 to light perception in the postoperative period. Best-corrected visual acuity improved in 15 (75%) eyes, remained the same in 4 (20%) eyes, and decreased in 1 (5%) eye. Postoperative complications included fibrinous exudation in 6 (30%) eyes, and VH in 3 (15%) eyes.Combined PPV, phacoemulsification and IOL implantation as well as the two-step procedure are safe and effective for the management of cataract in PDR. Sequential surgery could be advantageous to BCVA outcomes by minimizing postoperative VH, which is significantly more frequent after combined surgery. |
| Databáze: | OpenAIRE |
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