Combined 23-Gauge Sutureless Vitrectomy and Clear Corneal Phacoemulsification in Patients With Proliferative Diabetic Retinopathy

Abstract

Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy was safe and effective. It may have not only the known advantages of conventional combined surgery but also additionally those such as faster visual rehabilitation and less conjunctival fibrosis.

Complex Retinal Detachment in Phakic Patients

“…However, combined phacovitrectomy may lead to anterior segment complications such as optic/iris capture, posterior synechia, capsular phimosis, and secondary pupillary block. 3,5,6,10,12,20,21 This development may be due to the displacement of the lens anteriorly from the vitreous tamponade, possibly in combination with an inflammatory response after vitrectomy and endophotocoagulation. 3,5 After combined phacovitrectomy, the anterior segment outcomes reported in the literature are variable, including up to 55.8% of patients with elevated IOP, 6,14,18,21 between 4% and 22% with fibrin formation, 6,18 between 7% and 30% with posterior synechia, 11,18 and up to 33% with posterior capsule opacification.…”

“…3,5 After combined phacovitrectomy, the anterior segment outcomes reported in the literature are variable, including up to 55.8% of patients with elevated IOP, 6,14,18,21 between 4% and 22% with fibrin formation, 6,18 between 7% and 30% with posterior synechia, 11,18 and up to 33% with posterior capsule opacification. 6,10,20,26 In addition, in case the vitreoretinal surgeon does not perform the cataract surgery, combined phacovitrectomy requires two surgeons, thus becoming logistically challenging.…”

To the Editor

“…In sutureless diabetic vitrectomy studies, however, the incidence of early postoperative hypotony was lower in combined surgery than in vitrectomy alone. 2,3 We suppose that sclerotomy wound leak and related endophthalmitis may be less in the combined surgery. It is more important in the early postoperative period before the conjunctival wound is completely healed.…”

Chandelier retroillumination-assisted cataract surgery during vitrectomy

“…[1][2][3][4] Nonethless, there is no fixed procedure for this surgical method. Although combined surgery seems effective and safe, it can be challenging because of insufficient red reflex caused by severe vitreous hemorrhage.…”