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R. Gonzalez–Salinas, R. Agurto–Rivera, A. Suárez–Licona, M. Gómez–Moncada, J. Zamarripa, G. Papa–Oliva, J. Colina–Luque, M. Ambesi–Impiombato, V. Morales–Canton, H. Quiroz–Mercado; Is There Difference Between via Pars Plana versus Clear Cornea Cataract Extraction Associated to Vitrectomy? . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5434.
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Purpose: Cataract extraction at the same time of vitrectomy is a well described procedure. There are many reports depicting the technique, but no one defines in a comparative study if clear cornea phacoemulsification or pars plana phacofragmentation is the most recommended technique. Our objective is to determine if cataract extraction via pars plana or via clear cornea, associated to vitrectomy, causes different degrees of corneal damage and to describe complications related to each technique. Methods: Prospective, comparative and randomized study. We included patients with diabetic retinopathy, vitreous haemorrhage and cataract, with no previous intraocular procedure that might have produced corneal damage. After informed consent, patients were randomized in two groups, group A (gA) treated with lensectomy via pars plana plus vitrectomy, and group B (gB) treated with clear cornea phacoemulsification plus vitrectomy. We compared corneal damage and post operative inflammation of the two groups. Also intra and post–operative complications were described. Results: 7 patients were randomized in gA and 4 patients in gB. Demographical characteristics, level of diabetic retinopathy and cataract degree were similar between the two groups. During the surgery midriasis was reduced in gA from 7.25 mm to 6.50 mm, and in gB from 7.00 mm to 5.25 mm. During follow up there were no significant differences concerning inflammation and intraocular pressure variation between the two groups. Endothelial cell count in gA had a loss of 8.3% vs 23.1% of gB (p< 0.005). Corneal mean thickness was 594µm for gA and 592µm for gB. One patient of gA developed post–operative rubeosis and intraocular lens dislocation. Conclusions: There is no difference in post–operative inflammation and IOP variation between the two procedures. Clear cornea phacoemulsification induces a higher degree of miosis and endothelial damage compared to pars plana lensectomy. On the other hand there seems to be higher risk of IOL dislocation related to pars plana lensectomy.
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