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Markatia Z, Hudson J, Leung EH, Sajjad A, Gibbons A. The Postvitrectomy Cataract. Int Ophthalmol Clin 2022; 62:79-91. [PMID: 35752887 PMCID: PMC10187786 DOI: 10.1097/iio.0000000000000440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
To review the recent literature regarding risk factors for cataract formation after vitrectomy, the challenges and management strategies for anterior segment surgeons when facing post-vitrectomy cataract surgery, and the visual outcomes of patients undergoing post-vitrectomy cataract surgery. Cataract surgery after vitrectomy can be safely performed to significantly improve the visual outcome in most post-vitrectomy patients, although final visual acuity is primarily limited by the patient’s underlying vitreoretinal pathology.
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Affiliation(s)
- Zahra Markatia
- Bascom Palmer Eye Institute / University of Miami, Miami, FL
| | - Julia Hudson
- Bascom Palmer Eye Institute / University of Miami, Miami, FL
| | - Ella H. Leung
- Baylor College of Medicine, Houston, TX
- Georgia Retina, Atlanta, Georgia
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Patel SB, Snyder ME, Riemann CD, Osher JM, Mi CW, Sisk RA. COMBINED PHACOEMULSIFICATION SURGERY WITH MULTIFOCAL INTRAOCULAR LENS IMPLANTATION AND PARS PLANA VITRECTOMY FOR SYMPTOMATIC VITREOUS OPACITIES. Retin Cases Brief Rep 2021; 15:724-729. [PMID: 30986810 DOI: 10.1097/icb.0000000000000873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To report surgical outcomes of combined vitrectomy for vitreous floaters and phacoemulsification surgery with multifocal intraocular lens implantation. METHODS Retrospective, interventional, noncomparative case series of five eyes from five patients who underwent same-day combined phacoemulsification surgeries with apodized, diffractive multifocal intraocular lens implantation for cataract and pars plana vitrectomy for symptomatic vitreous opacities, that is, floaters. Primary outcomes were distance and near visual acuities, and resolution of symptoms. Secondary outcomes included intraocular pressure, refractive outcomes, and surgical complications. RESULTS Mean logarithm of the minimum angle of resolution glare distance visual acuity improved from 0.36 (best-corrected Snellen 20/47) preoperatively to an uncorrected distance visual acuity of 0.05 (Snellen 20/23) at 6 months postoperatively (P = 0.042). All but one patient achieved multifocality with a near visual acuity of J2 or better. All patients noted subjective improvement in symptoms from floaters postoperatively. Mean intraocular pressure remained stable during follow-up. Two eyes ultimately required YAG capsulotomies for symptomatic posterior capsular opacification, one of which additionally received LASEK for refractive correction. CONCLUSION Multifocality and improvement in symptoms from symptomatic vitreous opacities were observed in this pilot series of carefully selected patients who underwent combined phacovitrectomy with multifocal intraocular lens implantation. A high rate of retinal tears was found in these patients. Appropriate caution should be taken in preoperative assessment and patient selection for the combined procedure.
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Affiliation(s)
- Sunny B Patel
- University of Cincinnati College of Medicine, Cincinnati, OH
| | - Michael E Snyder
- Cincinnati Eye Institute, Cincinnati, OH; and
- Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - Christopher D Riemann
- Cincinnati Eye Institute, Cincinnati, OH; and
- Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - James M Osher
- Cincinnati Eye Institute, Cincinnati, OH; and
- Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - Cindy W Mi
- Cincinnati Eye Institute, Cincinnati, OH; and
- Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
| | - Robert A Sisk
- Cincinnati Eye Institute, Cincinnati, OH; and
- Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio
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Patel SB, Snyder ME, Riemann CD, Foster RE, Sisk RA. Short-term outcomes of combined pars plana vitrectomy for epiretinal membrane and phacoemulsification surgery with multifocal intraocular lens implantation. Clin Ophthalmol 2019; 13:723-730. [PMID: 31114150 PMCID: PMC6485319 DOI: 10.2147/opth.s195928] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the functional and anatomical outcomes of combined phacovitrectomy with multifocal intraocular lens (mfIOL) implantation. Methods Retrospective, interventional, non-comparative case series of six eyes that received a combined phacoemulsification surgery with apodized, diffractive mfIOL implantation for cataract and pars plana vitrectomy (PPV) with membrane peeling for epiretinal membrane (ERM). Outcome measures included distance and near visual acuities (DVA and NVA), central macular thickness (CMT), intraocular pressure (IOP), and disruption of external limiting membrane (ELM) or inner-segment outer-segment (IS/OS) junction. Results Mean logMAR glare DVA improved from 0.40 (Snellen 20/50) preoperatively to a mean uncorrected DVA of 0.038 (Snellen 20/22) (P=0.004) at 6 months after surgery. All eyes achieved NVA of J2 or better by 12 months postoperatively. Median CMT improved by 10 µm and mean IOP increased by 1 mmHg at 12 months postoperatively. Percentage of patients with ELM or IS/OS disruptions decreased from 66.7% to 33.3%. Two eyes demonstrated residual metamorphopsia on Amsler grid testing postoperatively. Postoperatively, four eyes required laser capsulotomy and one required LASEK for refractive correction. Conclusion Combined phacovitrectomy, membrane peeling, and mfIOL implantation improved VA in patients with idiopathic ERM. Multifocality was achieved, but final visual outcome was delayed due to posterior capsular opacification and macular healing.
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Affiliation(s)
- Sunny B Patel
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA,
| | - Michael E Snyder
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA, .,Cincinnati Eye Institute, Cincinnati, OH, USA,
| | - Christopher D Riemann
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA, .,Cincinnati Eye Institute, Cincinnati, OH, USA,
| | - Robert E Foster
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA, .,Cincinnati Eye Institute, Cincinnati, OH, USA,
| | - Robert A Sisk
- Department of Ophthalmology, University of Cincinnati, Cincinnati, OH, USA, .,Cincinnati Eye Institute, Cincinnati, OH, USA,
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Fu M, Lu X, Hu H, Feng S, Wu W, Ke X, Xu X, Chen X, Hai H. Effect of three-dimensional reconstruction-assisted 23G micro-invasive vitrectomy in patients with proliferative diabetic retinopathy. Exp Ther Med 2017; 13:2912-2916. [PMID: 28587359 PMCID: PMC5450687 DOI: 10.3892/etm.2017.4339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 02/17/2017] [Indexed: 01/07/2023] Open
Abstract
In the present study, we investigated the effect of optical coherence tomography (OCT) three-dimensional reconstruction-assisted 23G micro-invasive vitrectomy (abbreviated to'23G') in patients with proliferative diabetic retinopathy (PDR). A total of 66 PDR patients (66 eyes) were continuously selected and randomly divided into the control and observation groups with 33 patients in each group. Patients in the control group were treated with routine OCT examination while the patients in the observation group were treated with OCT three-dimensional retinal reconstruction. The 23G surgical method was applied to the two groups, and a comparison was made on the clinical effects in the two groups. The follow-up visits lasted for approximately 6 months, and it was found that the operative time, occurrence rate of intraoperative complications and postoperative complications as shown in the observation group were significantly less than those in the control group (P<0.05). The best corrected visual acuity (BCVA) was improved, the intraocular pressure was increased and retinal thickness was decreased after the treatment. The BCVA of patients in the observation group was significantly greater than that of patients in the control group while the intraocular pressure and retinal thickness of patients in the observation group were significantly less than those of patients in the control group (P<0.05). In conclusion, the effect of 23G surgical method in PDR patients can be improved and corresponding complications can be reduced under the assistance of OCT three-dimensional reconstruction.
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Affiliation(s)
- Min Fu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Xiaohe Lu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Huijun Hu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Songfu Feng
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Wei Wu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Xiaoyun Ke
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Xiaoping Xu
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Xiaohong Chen
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
| | - Huiqiao Hai
- Department of Ophthalmology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong 510280, P.R. China
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Zhao Y, Li J, Yang K, Li X, Zhu S. Combined Special Capsular Tension Ring and Toric IOL Implantation for Management of Astigmatism and High Axial Myopia with Cataracts. Semin Ophthalmol 2016; 33:389-394. [PMID: 28005433 DOI: 10.1080/08820538.2016.1247181] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Yang Zhao
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jiaxin Li
- Medical School, Pingdingshan University, Pingdingshan, China
| | - Ke Yang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiao Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Siquan Zhu
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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