Abstract
Purpose :
Phakic patients undergoing pars plana vitrectomy (PPV) for epiretinal membrane (ERM), macular hole (MH), or rhegmatogenous retinal detachment (RRD) often necessitate subsequent cataract surgery within 1–2 years. This retrospective clinical study investigates the clinical and anatomic outcomes, along with complication rates, of combined phacovitrectomy, a single-surgery approach offering cost savings and reduced anesthesia risks compared to sequential surgeries.
Methods :
Using CPT codes, subjects undergoing phacoemulsification concurrently with PPV with the same corneal and vitreoretinal surgeons (2010-2022) were identified. Exclusions were applied for trauma, infectious diseases, proliferative diabetic retinopathy, and specific systemic conditions. Data collection included demographics, exam findings, and surgical indications. Post-operative best-corrected visual acuity (BCVA, shown as LogMAR), anatomic improvements, and complication rates were assessed at defined intervals. Data was shown as mean (±SEM).
Results :
A total of 211 patients and 214 eyes were analyzed, with 51 eyes (43.14% ERM, 17.65% MH, 25.49% RRD, 7.84% vitreomacular traction, 5.88% non-clearing vitreous hemorrhage) of 51 patients meeting inclusion criteria. Mean age was 65.58 (±1.37), with 58.82% females. The mean follow-up was 19.21 months. Post-operative BCVA significantly improved at 3 months (0.79 ± 0.09, P=0.0014), 6 months (0.76 ± 0.10, p<0.001), and the last visit (0.74 ± 0.11, P<0.001). Anatomic improvement was observed in 91% of cases compared to pre-operation. The most common complication was cystoid macular edema (17.65%). Recurrence rates for ERM and RD were 3 of 22 eyes and 3 of 13 eyes, respectively, with 11.76% of eyes requiring reoperation. No intraoperative complications occurred, and intraoperative anatomic goals were universally achieved.
Conclusions :
Phacovitrectomy emerges as a safe and effective strategy for simultaneously addressing visual and anatomic concerns in vitreoretinal diseases with macular indications. Post-operative complication rates were low, historically comparable with rates in PPV alone cases.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.