Abstract
Abstract: :
Purpose: To evaluate the postoperative outcomes after combined surgery and sequential surgery comprising phacoemulsification, IOL implantation, ppv and peeling in patients affected by idiopathic macular epiretinal membranes and cataract Methods: We performed a retrospective study on 24 eyes of 23 patients aged between 56 and 78 years (mean 68,37 years), operated between January 2000 and December 2002, with a follow up of 6 months after phacoemulsification. We performed complete ocular examination with visual acuity for far and near record, fluorescein angiography and OCT scans on the macula to mesure foveal thikness in all patients. We designed 2 groups: Group A: 12 eyes of 12 patients, mean age 72 years, who underwent combined surgery, that is phacoemulsification, IOL implantation, minimal ppv and peeling of posterior hyaloid, epiretinal membranes and occasionally ILM. Group B: 12 eyes of 11 patients, mean age 64,75 years, who underwent sequential surgery, that is minimal ppv and peeling of posterior hyaloid, epiretinal membranes and occasionally ILM and after an average time og 16 months phacoemulsification and IOL implantation. Results: We recorded an improvement in visual function in both groups (mean improvement in VA for far 2.6 in group A and 2.54 in group B; mean improvement in VA for near 2.25 in group A and 3.17 in group B) and decrease in foveal thickness in both group (mean decrease 29% in group A and 35% in group B): We recorded postoperative cystoid macular edema in only one case in group A. Conclusions: Our results confirm that combined surgery is useful in patients with idiopathic epimacular membranes and cataract and that functional recovery is faster; after sequential surgery visual improvement for near seems to be better.
Keywords: vitreoretinal surgery • cataract • macula/fovea