Postoperative Outcomes of Combined Phacovitrectomy for Epiretinal Membrane With a Concurrent Cataract vs Standalone Phacoemulsification for a Cataract

Purpose: To compare the postoperative outcomes after combined phacovitrectomy for epiretinal membrane (ERM) and cataract (combined group) vs standalone phacoemulsification (control group). Methods: A systematic literature search of Ovid MEDLINE, CINAHL, and the Cochrane Library was performed. The primary outcomes were the refractive prediction error and mean absolute error expressed as the spherical equivalent. A secondary outcome was the best-corrected visual acuity (BCVA). The weighted mean prediction error was calculated, and the mean absolute error outcomes were combined for a meta-analysis. When a meta-analysis was not feasible, a narrative synthesis was performed. Results: Of 3632 articles identified in the database search, 6 retrospective case control studies and 1 prospective case study met the inclusion criteria. The 7 studies comprised a total of 584 eyes (combined group, 278 eyes; control group, 306 eyes). The combined weighted mean (+/- SD) prediction error was -0.41 +/- 0.85 D in the combined group, showing a myopic shift, and 0.09 +/- 0.45 D in the control group. The meta-analysis for the postoperative mean absolute error showed a significant difference between groups (mean deviation, 0.10; 95% CI, 0.02-0.17; P = .01), favoring the control group. The mean BCVA was 0.34 +/- 0.21 logMAR in the combined group and 0.575 +/- 0.23 logMAR in the control group (Snellen equivalent, 6/12 and 6/19, respectively). Conclusions: The results of the meta-analysis showed that phacovitrectomy for ERM and concurrent cataract leads to higher prediction errors than standalone phacoemulsification for cataract. However, the postoperative BCVA was comparable between the 2 procedures.