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D. S. Liao, J. S. Heier; Outcomes of Combined Vitreoretinal and Anterior Segment Procedures. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5989.
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In patients requiring surgical management of vitreoretinal diseases, there is often concomitant anterior segment pathology. Combined vitrectomy and anterior segment surgery provides the benefit of a single procedure with less postoperative recovery time. However, combined surgery presents a unique set complications. In this study, we describe operative outcomes and complications of combined vitreoretinal and anterior segment surgery for various disease states.
A retrospective review of 154 patients (158 eyes) undergoing combined pars plana vitrectomy with various anterior segment procedures. Indications for vitrectomy included IOL subluxation (45), complex cataract (60), retained lens fragments (8), aphakia (5), retinal detachment (8), complications of proliferative diabetic retinopathy (7), macular hole (2), epiretinal membrane (14), glaucoma (4), and silicone oil removal (5). Mean followup time was approximately 6 months (187 days).
Visual acuity improved or remained stable in 88.7% of eyes. Common complications included hyphema (5.0%), elevated IOP (4.4%), RD (5.0%), CME (3.1%), and hyptony (2.5%). Some complications had a higher incidence depending on the type of procedure, such as hyphema associated with removal of dislocated IOL (13.3%).
Combination vitrectomy and anterior segment surgery is a viable alternative to sequential procedures for a variety of disease states. In this relatively large case series, there was good visual rehabilitation with a low rate of complications.
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