May 2004
Volume 45, Issue 13
ARVO Annual Meeting Abstract  |   May 2004
Anterior segment outcome after combined extracapsular cataract extraction and pars plana vitrectomy
Author Affiliations & Notes
  • A.J. Mueller
    University Eye Hospital LMU, Munich, Germany
  • C. Tribus
    University Eye Hospital LMU, Munich, Germany
  • K. Klinger
    University Eye Hospital LMU, Munich, Germany
  • Footnotes
    Commercial Relationships  A.J. Mueller, None; C. Tribus, None; K. Klinger, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 2014. doi:
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      A.J. Mueller, C. Tribus, K. Klinger; Anterior segment outcome after combined extracapsular cataract extraction and pars plana vitrectomy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2014.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: To analyze the anterior segment outcome after extracapsular cataract extraction (ECCE) with PCIOL insertion combined with pars plana vitrectomy (ppv) when performed as a single step procedure. Methods: 513 consecutive patients were retrospectively analyzed. Main outcome measurements were postoperative signs for inflammation such as cells, flare, fibrin, posterior synechiae, postoperative elevation of intraocular pressure, decentration of PCIOL, posterior capsular opacification and clinically evident cystoid macular edema. A multivariate analysis was performed correlating the main outcome measurements with the underlying diseases, the type of PCIOL, the implantation site of the PCIOL, the surgeon, the use of endolaser and/or exocryo and the intraocular tamponade. Results: Indications for vitrectomy were: diabetic retinopathy (161 (31%)), macular hole (117 (23%)), epiretinal membranes or macular pucker (91 (18%)), rhegmatogenous retinal detachment (65 (13%)), vitreoretinal traction syndrome (27 (5%)), vitreous hemorrhage secondary to other diseases (21 (4%)), vitreous hemorrhage secondary to retinal vessel occlusions (20 (4%)), uveitis (12 (2%)). Intraocular tamponade was in 164 eyes (32%) balanced salt solution, in 75 eyes (15%) air, in 230 eyes (45%) C2F6, and in 44 eyes (9%) silicone oil. 498 (97%) of the PCIOLs were inserted in the capsular bag, 15 (3%) in the ciliary sulcus. In 238 (46%) eyes laser coagulation was performed intraoperatively, and in 11 (2%) cryocoagulation. Postoperative anterior chamber cells were 0 in 22 eyes (4%), 1+ in 280 eyes (54%), 2+ in 175 eyes (34%), and 3+ in 36 eyes (7%). 166 eyes had (32%) no flare postoperatively, 277 eyes (55%) had 1+ flare, 62 eyes (12%) had 2+ flare, and 8 eyes (2 %) had 3+ flare. 56 (11%) patients had mild fibrin in the anterior chamber. 212 (41%) patients didn’t have IOP increase postoperatively, 193 (38%) had an postop IOP of 22–30mmHg, 79 (15%) 31–40mmHg, and 29 (6%) more than 41mmHg. PCIOL–decentration was found in 6 patients (1%). 23 (5%) patients developed posterior capsular opacification during follow up. Clinically evident cystoid macular edema was found in 4 (<1%) patients. There was no statistically signnificant correlation found between the of anterior segment outcome and any of the investigated factors. Conclusions: The combination of ppv with ECCE and PCIOL insertion is a safe and effective single step procedure. Mild to moderate anterior segment inflammation might occur but is not correlated to the underlying retinal disease or another investigated single factor.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • anterior segment • vitreoretinal surgery 

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