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A. Muselier, Jr., M. Passemard, Jr., A. Sayen, Jr., A. Guillaubey, Jr., A. Bron, Sr., J. Berrod, Sr., C. Creuzot Garcher, Sr.; Macular Hole and Cataract Extraction: Combined Surgery vs. Two Times Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4700.
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To compare functional and anatomical results of a combined surgery and two time surgery for macular hole and cataract extraction.
We retrospectively collected charts of phakic patients operated for stage 3 or 4 macular hole between 2006 and 2007 in two academic centers. We compared the results obtained with combined or two time surgery of macular hole and cataract. Main end points were best corrected visual acuity (BCVA), anatomic result of macular surgery and the rate of complication.
Thirty-two eyes were included. Mean follow up was 18 ± 6 months. Sixteen patients underwent combined surgery (group 1) and 16 patients underwent successive procedures (group 2). Every patient underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade. The mean age, size and BCVA of the two groups were not different: 69 vs 71 years (p=0,22); macular hole size 485 µm vs 403µm (p=0,085) and 1,1 LogMar vs 0,93 LogMar (p=0,33) respectively. The mean increase in BCVA was significant for both groups after surgery, the BCVA improvement was 0.68 logMar in group 1 and 0.59 logMar in group 2 (p=0.79).Two cases of anatomic failure were noted in both groups. No other serious complications were observed.
Both combined and successive surgeries are safe and effective methods to treat macular hole and cataract. However the combined procedure lowered the total cost of surgery and improved the functional benefit for the patient whose visual acuity recovery is faster.
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