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L Al-Attar, WE Smiddy, J Schiffman; Comparison of Foldable Versus Nonfoldable Intraocular Lenses in Conjunction with Pars Plana Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3500.
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Purpose: To compare results using a foldable acrylic intraocular lens (IOL) through a clear cornea incision versus a nonfoldable polymethylmethacrylate IOL (PMMA) with scleral incision in eyes undergoing IOL insertion during pars plana vitrectomy (PPV) Methods: A retrospective chart review of two consecutive groups of patients. Group 1 included 30 eyes in 30 consecutive patients undergoing PPV and IOL insertion with a foldable IOL between May 15, 1999 and November 1, 2000. Group 2 included 30 eyes in 29 consecutive patients undergoing PPV and IOL insertion with a PMMA IOL between April 1, 1996 and May 15, 1999. Preoperative data including age, sex, eye, initial best corrected visual acuity (BCVA), diagnosis, previous surgery and lens status were recorded. PPV and associated vitreoretinal procedures were performed as indicated by individual circumstances. Intraoperative data included optic size and associated vitreoretinal procedures. Outcome measures included final BCVA, best BCVA, number of pressure lowering medications needed to control intraocular pressure (IOP), IOP ≷30, final attachment status of the retina, complications, need for subsequent surgery, and follow-up duration. Results: The two groups had similar baseline characteristics including sex, age, preoperative visual acuity and phakic state. The diagnoses at PPV were similar in the two groups, except that Group 1 had more patients with proliferative diabetic retinopathy. Both groups had similar frequencies of previous surgery. The foldable IOL optic lengths were either 5.5 mm or 6 mm. The PMMA IOL optic lengths were mostly 7 mm, and rarely 6.5 mm. Both forms of the IOL were successfully implanted in all eyes and did not pose any difficulty in examining the fundus or cause any vitreoretinal complications. Group 2 had longer follow-up duration (mean of 621 days vs. 174 days) because of the earlier time period of surgery. Complication rates were similar in the two groups and included recurrent retinal detachment, recurrent macular hole, elevated IOP, cystoid macular edema, posterior capsular opacity, giant retinal tear, and endophthalmitis. Further intervention was required in 7 eyes of Group 1 and 11 eyes of Group 2 and included anterior chamber tap, repeat PPV with indicated vitreoretinal procedure, Yag capsulotomy, and cryopexy. The retina was attached at the last visit in all but one eye in each group. Group 1 was not more likely to require glaucoma drops and was not more likely to have IOP≷30 postoperatively. Conclusion: Results with acrylic IOLs are comparable to results with PMMA nonfoldable IOLs and may be safely implanted in conjunction with PPV in selected cases.
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