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M. J. Ko, A. J. Barkmeier, P. E. Carvounis, J. L. Heffez, E. R. Holz; Combined Vitrectomy and Cataract Extraction with Intraocular Lens Implantation for Vitreomacular Traction Syndrome with Cataract. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6086.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate functional results of combined vitrectomy and cataract extraction with intraocular lens implantation (CE/IOL) for vitreomacular traction syndrome (VMT) with cataract
Retrospective, interventional, consecutive case series. Included are 12 eyes of 10 consecutive patients who underwent combined vitrectomy and CE/IOL for VMT and cataract at a single institution from 1998 - 2006. An additional 13 eyes of 13 consecutive phakic patients who underwent vitrectomy for VMT without combined cataract surgery are included for comparison. Patient demographics, medical and ocular history, and clinical data were recorded.
Mean patient age for eyes who underwent combined surgery vs. those with vitrectomy only was 63.2 +/- 10.6 and 65.0 +/- 8.5 years, respectively, and mean follow-up was 31.8 +/- 15.9 and 22.0 +/- 16.2 months, respectively. 7 of the 13 phakic eyes underwent CE/IOL during follow-up. Mean pre-operative vision for eyes who underwent combined surgery vs. those with vitrectomy only was 20/122 and 20/91 (logMAR 0.79 and 0.66), improving to 20/53 and 20/60 at 1-3 months (logMAR 0.43 and 0.48), 20/38 and 20/65 at 3-6 months (logMAR 0.28 and 0.51), 20/36 and 20/65 at one year (logMAR 0.25 and 0.51), 20/40 and 20/53 at last follow-up (logMAR 0.30 and 0.43), and 20/33 and 20/41 for the best post-operative acuity (logMAR 0.22 and 0.31). Intergroup differences in visual improvement were statistically significant in favor of the combined surgery group at 3-6 months (p=0.003), one year (p=0.008), and last follow-up (p=0.039), but not at 1-3 months (p=0.165) or for the best post-operative acuity (p=0.065). Four patients in each group had pre- and post operative optical coherence tomography (OCT) testing, and each demonstrated retinal thinning (521 +/- 124 to 232 +/- 132 microns [p=0.019] and 521 +/- 339 to 213 +/- 15 microns [p=0.17], respectively).
Combined vitrectomy and cataract extraction for VMT and cataract offers excellent functional outcomes for patients with these conditions. These patients had better visual acuity at all follow-up points compared to phakic VMT patients who underwent vitrectomy only, with or without eventual cataract extraction. Combined surgery should be considered in VMT patients with significant cataract
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