Abstract
Purpose :
To report the outcome of same day, sequential anterior segment surgery followed by posterior segement surgery on forty patients.
Methods :
Patients can have pathologies on the eye requiring more than one surgery. This study aimed to examine the effectiveness of combining these surgeries under one setting in the operating room. This is a retrospective review of same day, sequential anterior segment surgery followed by posterior segment surgery on forty patients to observe the outcome when compared the reported outcomes of performing these surgeries on separate days.
Results :
Sequential, same day anterior and posterior segment surgery were perfomed successfullly in forty patients who were followed for an average of over a twelve month period. Average initial visual acuity (VA) and final VA measured in logmars were 1.217 (39 patients / 47.44 logmars), and 0.847 logmars (39 patients / 33.02 logmars), respectively. Average final lines of VA gained was 2.414 (91.75 lines / 38 patients). % of patients with 3 lines of VA gained at 6 months was 30% (9/30). % of patients with 3 lines of VA gained at 12 months was 44.83% (13/29). % of patients with 3 lines of final VA gained was 51.35% (19/37). % of patients of 3 line VA loss at 6 months was 3.33% (1/30). % of patients of 3 line VA loss at 12 months was 6.67% (2/30). % of patients of 3 line final VA loss was 2.7% (1/37). Reeoperation rate was 17% (7/41), and included, recurrent tractional retinal detachment (TRD), (4) corneal graft failure(1), iris neovascularization, hyphema, and non-clearing vitreous hemorrhage (1), and rhegmatogenous retinal detachment (1).
Conclusions :
Combined anterior and posterior segment surgery is a safe and effective option in a private practice setting. This series of patients encompassed a wide variety of surgical pathologies that ranged from typical degenerative cataracts combined with epiretinal membranes to highly complex trauma that necessitated corneal transplantation and complex retinal reattachment. Despite many eyes having severe and complex pathology, the incidence of significant vision loss was only 2.7%. This compares quite favorably with the reported rates of visual loss with vitrectomy surgery and cataract surgery when performed separately. Further subgroup analysis is required to determine which pathologies are associated with increased reoperative rates.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.