July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Visual, Refractive and Anatomic Outcomes of Combined Versus Sequential Phacoemulsification and Vitrectomy in Patients with Epiretinal Membrane or Full-thickness Macular Hole
Author Affiliations & Notes
  • Harrison Dermer
    University of Miami Miller School of Medicine, Miami, Florida, United States
    Miami Veterans Affairs Medical Center, Florida, United States
  • Rehan Hussain
    Bascom Palmer Eye Institute, Miami, Florida, United States
    Miami Veterans Affairs Medical Center, Florida, United States
  • James Lin
    Bascom Palmer Eye Institute, Miami, Florida, United States
    Miami Veterans Affairs Medical Center, Florida, United States
  • Elizabeth A. Vanner
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Luis J Haddock
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Ninel Gregori
    Bascom Palmer Eye Institute, Miami, Florida, United States
    Miami Veterans Affairs Medical Center, Florida, United States
  • Footnotes
    Commercial Relationships   Harrison Dermer, None; Rehan Hussain, None; James Lin, None; Elizabeth Vanner, None; Luis Haddock, None; Ninel Gregori, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1013. doi:
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      Harrison Dermer, Rehan Hussain, James Lin, Elizabeth A. Vanner, Luis J Haddock, Ninel Gregori; Visual, Refractive and Anatomic Outcomes of Combined Versus Sequential Phacoemulsification and Vitrectomy in Patients with Epiretinal Membrane or Full-thickness Macular Hole. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1013.

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

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Abstract

Purpose : Epiretinal membrane (ERM) or full-thickness macular hole (MH) frequently coexist with a cataract in the elderly, and may be addressed either simultaneously or sequentially. It remains unclear whether the temporal relation of the procedures influences outcomes. To address this, we retrospectively reviewed eyes treated with phacoemulsification and pars plana vitrectomy (PPV) concurrently (combined) and those that underwent procedures within one year of each other (sequential).

Methods : Consecutive case series. Snellen VA (converted to approximate ETDRS letter scores) and optical coherence tomography (OCT) central foveal thickness and macular volume at pre-operative (baseline) and post-op visits at 1 (POM1), 3-6, and 12 months were analyzed and compared. Refractive error (RE) was calculated as the difference between predicted spherical equivalence (SE) by SRK/T and Holladay formulas and the achieved SE measured at POM1 and last examination after combined or 2nd sequential surgery.

Results : 126 eyes were analyzed: 64.3% underwent combined and 35.7% had sequential procedures. Of sequential surgeries, 73.3% had phacoemulsification first, while 26.7% had PPV first. There were no significant differences in age, gender, laterality, axial length, or time since surgery between the groups. In the combined group, the mean best-corrected visual acuity (BCVA) improved from baseline by 40±31, 51±27, 54±25 letters at 1, 3-6, and 12 months respectfully. In the sequential group, the mean BCVA improved by 52±21, 56±24, 57±25 letters at 1, 3-6, and 12 months. Comparing the groups, the mean BCVA differed significantly only at POM1 (p=0.0192), but there were no significant differences in mean VA change from baseline. The achieved SE and the mean RE did not differ between the groups at POM1 or the last examination. No significant differences in the mean change from baseline in OCT central foveal thickness or macular volume were identified between the combined and sequential groups at any time point.

Conclusions : Combined and sequential phaco-vitrectomy procedures produced similar results with respect to visual, refractive and anatomical outcomes in both the ERM and MH populations assessed.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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