Facoemulsificação, vitrectomia via pars plana e implante de lente intra-ocular em olhos com retinopatia diabética proliferativa

Translated title of the contribution: Phacoemulsification, pars plana vitrectomy and intraocular lens implant in eyes with proliferative diabetic retinopathy

Armando Belfort Mattos, Pedro Paulo De Oliveira Bonomo, Lincoln Lemes Freitas, Michel Eid Farah, Harry Flynn, Maurício Bastos Pereira

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: To evaluate the outcomes and the best technique for a combined phacoemulsification (PHACO), pars plana vitrectomy (PPV) and posterior chamber intraocular lens insertion (PCIOL) in one single procedure for patients with proliferative diabetic retinopathy. Methods: We reviewed charts of 47 (53 eyes) patients with proliferative diabetic retinopathy who underwent combined phacoemulsification with posterior chamber intraocular lens implant and pars plana vitrectomy performed between January 1991 and September 1998 at the Bascom Palmer Eye Institute, eye hospital affiliated with the University of Miami. The study was done in conjunction with the Federal University of Säo Paulo. A total of 43 eyes from 40 patients were elected to participate in the study. Results: The follow-up range was three to 60 months (mean 20 months). The age ranged from 37 to 77 years with a mean of 59. Preoperative visual acuity improved two lines or more in 26 (60.4%) eyes, remained the same in 9 (20.9%) and got worse in 8 (18.6%). In 10 (23.2%) eyes visual acuity improved to 20/40. The study showed to be statistically significant for the improvement of the final visual acuity. Recurrent vitreous hemorrhage was the most frequent postoperative complication found in 12 (27.9%) eyes and it was followed by transient anterior chamber reaction in 9 (20.9%) eyes. Intraoperative and postoperative complications related to phacoemulsification were rare. IOL capture was found in 2 (4.6%) eyes and intraocular lens subluxation in 1 (2.3%) eye. Conclusion: Combined phacoemulsification with posterior chamber intraocular lens implant and pars plana vitrectomy in proliferative diabetic retinopathy is a feasible procedure, well-tolerated and usually presents significant visual acuity improvement. One single procedure, to remove the cataract and to perform pars plana vitrectomy, instead of performing a second surgery that would be only to remove the cataract after the pars plana vitrectomy is safe, improves visual acuity and is also less aggressive for the patient. The potential for improving final visual acuity is limited by the severity of retinopathy.

Translated title of the contributionPhacoemulsification, pars plana vitrectomy and intraocular lens implant in eyes with proliferative diabetic retinopathy
Original languagePortuguese
Pages (from-to)441-449
Number of pages9
JournalArquivos Brasileiros de Oftalmologia
Volume67
Issue number3
DOIs
StatePublished - 2004

Keywords

  • Cataract extraction
  • Diabetic retinopathy/surgery
  • Lenses, intraocular
  • Phacoemulsification/ methods
  • Vitrectomy

ASJC Scopus subject areas

  • Ophthalmology

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