Combining phacoemulsification with pars plana vitrectomy in patients with proliferative diabetic retinopathy - A series of 223 cases

Purpose: To describe the results of combined phacoemulsification, insertion of posterior chamber intraocular lens (PCIOL), and pars plana vitrectomy for patients with retinal disorders resulting from diabetic retinopathy. Design: Retrospective, consecutive, noncomparative, interventional case series. Participants: Two hundred twenty-three patients with vitreorentinal disorders secondary to diabetic retinopathy. Methods: A case series of 223 consecutive patients with retinal disorders resulting from diabetic retinopathy who underwent combined phacoemulsification, insertion of PCIOL, and pars plana vitrectomy. Main Outcome Measures: Vision, number of secondary procedures, and complications. Results: Two hundred twenty-three patients (153 with vitreous hemorrhage, 58 with traction retinal detachment, and 12 with macular traction) underwent combined surgery. The average increase in vision was 4.3 Snellen lines. The average follow-up was 10 months. Retinal detachment occurred in 5% of patients who underwent surgery. Diabetic macular edema was found in 12% after combined surgery. Cystoid macular edema was found in 3%. Vitreous hemorrhage requiring another procedure occurred in 11%. Twenty-two patients (10%) required a repeat vitrectomy (112 for vitreous hemorrhage and 10 for retinal detachment). Conclusions: Combined phacoemulsification, insertion of PCIOL, posterior capsulectomy, and pars plana vitrectomy can be used to treat patients with complications resulting from proliferative diabetic retinopathy. Combined surgery may prevent a second operation for postvitrectomy cataract, allowing earlier visual rehabilitation. (C) 2002 by the American Academy of Ophthalmology.