1
|
Devireddy N, Borkhetaria R, Cannon N, Bowie E, Pantanelli SM. Cataract Outcomes Following Scleral Buckle Surgery for Retinal Detachment. Clin Ophthalmol 2024; 18:1225-1233. [PMID: 38737596 PMCID: PMC11088403 DOI: 10.2147/opth.s457416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose To investigate refractive, visual, and safety outcomes of cataract surgery performed after scleral buckling (SB) for retinal detachment (RD). Patients and methods A chart review at an academic medical center identified eyes with history of SB followed by subsequent cataract extraction between 2010 and 2022. Eyes with less than 3 weeks follow-up, silicone oil at time of biometry measurement, previous cornea surgery, or co-existing pathology impacting refractive outcomes were excluded. Predicted postoperative spherical equivalents (SE) were calculated with the Barrett Universal II (BU2), Kane, and SRK/T formulas for the implanted intraocular lens (IOL), and complications occurring within 1 year of surgery were abstracted. Results Sixty eyes of 60 patients met criteria for inclusion, and 40 (66.7%) had postoperative refraction recorded. Absolute prediction errors were 0.49, 0.45, and 0.52D with BU2, Kane, and SRK/T, respectively. Actual postoperative refraction was within 0.5 and 1.0 D of predicted in 26 (65.0%) and 36 (90.0%) using BU2, 23 (58%) and 37 (93%) using Kane, and 21 (52.5%) and 36 (90.0%) using SRK/T. In eyes with macula-on RD, corrected distance visual acuity (CDVA) of logMAR 0.301 (≈20/40) and logMAR 0.544 (≈20/70) or better was achieved in 12 (75.0%) and 15 (93.8%) of eyes. For macula-off RD eyes, these proportions were 19 (63.3%) and 24 (80.0%), respectively. Posterior capsular opacification requiring Nd: YAG capsulotomy was the most frequent complication in 30 (56.7%) eyes. Conclusion Refractive outcomes of cataract surgery following SB may be modestly reduced, even when using modern formulas. Nevertheless, cataract surgery in this population results in favorable visual outcomes.
Collapse
Affiliation(s)
- Nitya Devireddy
- Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA
| | - Rucha Borkhetaria
- Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA
| | - Nathan Cannon
- Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA
| | - Esther Bowie
- Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA
| | - Seth M Pantanelli
- Department of Ophthalmology, Penn State College of Medicine, Hershey, PA, USA
| |
Collapse
|
2
|
Momenaei B, Wakabayashi T, Kazan AS, Oh GJ, Kozarsky S, Vander JF, Gupta OP, Yonekawa Y, Hsu J. Incidence and Outcomes of Recurrent Retinal Detachment after Cataract Surgery in Eyes with Prior Retinal Detachment Repair. Ophthalmol Retina 2024; 8:447-455. [PMID: 37989465 DOI: 10.1016/j.oret.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To investigate the incidence and outcomes of recurrent retinal detachment (RD) after cataract extraction (CE). DESIGN Retrospective case series. SUBJECTS Phakic eyes with RD that were successfully repaired with pneumatic retinopexy (PR), scleral buckle (SB), pars plana vitrectomy (PPV), or combined PPV/SB and subsequently underwent cataract surgery. METHODS A retrospective review of phakic eyes that underwent successful RD repair followed by subsequent cataract surgery between April 2012 and January 2023 was performed. Patients with multiple RD surgeries before CE and those with silicone oil tamponade before cataract surgery were excluded. Eyes that redetached were matched 1:2 with eyes that did not redetach after cataract surgery. MAIN OUTCOME MEASURES Incidence of redetachment after cataract surgery as well as visual and anatomic outcomes at 6 months after first redetachment and at the final visit. RESULTS Of 4833 phakic eyes at the time of initial RD, 1893 patients (39.2%) underwent cataract surgery. After applying exclusion criteria, 763 patients were included. The mean (standard deviation) duration of follow-up was 48.4 (29.1) months. The overall incidence of retinal redetachment after cataract surgery was 2.5% (19/763 eyes). The rate of redetachment based on the type of initial RD repair was 9.1% (1/11), 5.3% (2/38), 2.8% (9/317), and 1.8% (7/397) for PR, SB, PPV, and combined PPV/SB, respectively (P = 0.24). The median (interquartile range [IQR]; range) duration between the cataract surgery and first redetachment was 301 (104-1222; 8-2760) days. Single surgery anatomic success for the RD repair after cataract surgery was achieved in 17 eyes (89.5%) at 3 months and 14 eyes (73.7%) at 6 months and at the final visit. Final anatomic success rate for reattachment was 100% (19/19). The median (IQR) logarithm of the minimal angle of resolution visual acuity (VA) at the final visit was 1.00 (0.18-2.00, Snellen equivalent, 20/200) with significant worsening compared with vision after cataract surgery (0.18 [0.10-0.48], 20/30) (P = 0.001). CONCLUSION Recurrent RD was not uncommon in patients with a prior history of RD repair after CE. Reoperation resulted in relatively favorable anatomic success but there were declines in VA. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Bita Momenaei
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Taku Wakabayashi
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania
| | - Adina S Kazan
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Glenn J Oh
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Scott Kozarsky
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - James F Vander
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Omesh P Gupta
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason Hsu
- The Retina Service of Wills Eye Hospital, Wills Eye Physicians-Mid Atlantic Retina, Philadelphia, Pennsylvania; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
| |
Collapse
|
3
|
Forsell S, Mönestam E. Frequency of Retinal Redetachment after Cataract Surgery in Eyes with Previous Scleral Buckling Surgery. Ophthalmol Retina 2018; 2:4-9. [PMID: 31047301 DOI: 10.1016/j.oret.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the cumulative risk and outcome of retinal redetachment after cataract surgery, in eyes with a history of retinal detachment repair by scleral buckling techniques. DESIGN Population-based, retrospective cohort study. PARTICIPANTS All phakic patients without previous ocular surgery or significant trauma who underwent scleral buckling surgery for rhegmatogenous retinal detachment between January 1, 2001, and December 31, 2010, at Norrlands University Hospital, Sweden (n = 537). METHODS International Classification of Diseases 10 diagnosis codes corresponding to rhegmatogenous retinal detachment were used to identify all cases. Medical charts of all patients identified were reviewed to confirm the diagnosis. Any recurrence of retinal detachment and the visual outcome in these cases were examined. The frequency of redetachment and the time span from cataract surgery to redetachment surgery were analyzed. MAIN OUTCOME MEASURES Any redetachment surgery after cataract surgery, best-corrected visual acuity (BCVA). RESULTS Three hundred and one (56%) male and 236 (44%) female patients were identified. During the follow-up period, 145 of 537 patients (27%) had phacoemulsification surgery, with a median time span of 3.4 years after the retinal detachment repair. Male patients had cataract surgery significantly more often (31% vs. 22%; P = 0.036), and at an earlier age, than female patients (65.6 vs. 69.4 years; P = 0.013). Recurrence of retinal detachment occurred in 3 patients (3/145; 2.1%), at 2.4, 3.9, and 6.9 years after cataract extraction, and their final BCVA was 20/70, 20/25, and 20/30, respectively. The cumulative percentage of redetachment surgery after phacoemulsification was 1% up to 10 years after the scleral buckling surgery, as calculated by life table analyses. Ten years after cataract surgery, the cumulative percentage of redetachment surgery was 5% in eyes with previous scleral buckling surgery. CONCLUSIONS In patients with a history of previous scleral buckling surgery, the risk of redetachment after cataract surgery is low. In these patients, phacoemulsification can be performed safely and there is no need for extended postoperative attention. It is, however, important to inform all patients with previous retinal detachment surgery to seek prompt medical care if they experience symptoms of redetachment. This is important even several years after the cataract surgery was performed.
Collapse
Affiliation(s)
- Sara Forsell
- Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden.
| | - Eva Mönestam
- Department of Clinical Sciences/Ophthalmology, Faculty of Medicine, Umeå University, Umeå, Sweden
| |
Collapse
|
4
|
Greenberg PB, Tseng VL, Wu WC, Liu J, Jiang L, Chen CK, Scott IU, Friedmann PD. Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans. Ophthalmology 2010; 118:507-14. [PMID: 21035868 DOI: 10.1016/j.ophtha.2010.07.023] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Revised: 07/25/2010] [Accepted: 07/26/2010] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. DESIGN Retrospective cohort study. PARTICIPANTS Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. METHODS The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. MAIN OUTCOME MEASURES Intraoperative and postoperative ocular complications within 90 days of cataract surgery. RESULTS During the study period, 53786 veterans underwent cataract surgery; 45082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5%) and posterior capsular opacification after surgery (4.2%). Predictors of complications included: black race (OR, 1.38; 95% confidence interval [CI], 1.28-1.50), divorced status (OR, 1.10; 95% CI, 1.03-1.18), never married (OR, 1.26; 95% CI, 1.14-1.38), diabetes with ophthalmic manifestations (OR, 1.33; 95% CI, 1.23-1.43), traumatic cataract (OR, 1.80; 95% CI, 1.40-2.31), previous ocular surgery (OR, 1.29; 95% CI, 1.02-1.63), and older age. CONCLUSIONS In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations.
Collapse
Affiliation(s)
- Paul B Greenberg
- Section of Ophthalmology, VA Medical Center, Providence, Rhode Island 02908, USA.
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Clark C, Habib MS, Steel DH. Combined phacoemulsification and transpupillary removal of heavy silicone oil. J Cataract Refract Surg 2008; 34:1640-3. [PMID: 18812112 DOI: 10.1016/j.jcrs.2008.05.054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Accepted: 05/07/2008] [Indexed: 10/21/2022]
Abstract
We describe a technique for heavy silicone oil removal combined with phacoemulsification and intraocular lens insertion without scleral incisions or sutures using a modified 16-gauge cannula. The technique is less invasive than other techniques for removing silicone oil and does not interfere with the uveal tract or the peripheral retina.
Collapse
|
6
|
Cataract extraction after retinal detachment repair by vitrectomy : visual outcome and complications. Eye (Lond) 2008; 23:1377-81. [DOI: 10.1038/eye.2008.255] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
7
|
Covert DJ, Wirostko WJ, Han DP, Lindgren KE, Hammersley JA, Connor TB, Kim JE. Risk factors for scleral buckle removal: a matched, case-control study. Am J Ophthalmol 2008; 146:434-439. [PMID: 18614132 DOI: 10.1016/j.ajo.2008.05.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2008] [Revised: 05/13/2008] [Accepted: 05/14/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify preoperative, perioperative, and postoperative risk factors for scleral buckle (SB) removal. DESIGN Retrospective, consecutive, matched, case-control study. METHODS Cases included all patients undergoing SB removal between August 1988 and December 2007 at a single academic center. Cases were matched against four randomly selected control patients who underwent SB implantation during the same year as the case. Odds ratios (OR) were calculated for each factor investigated. RESULTS Forty cases of SB removal and 148 matched control cases were identified. Three cases of SB removal were omitted from analysis because of incomplete records. Factors associated with SB removal for any reason, using univariate analysis, included concurrent globe-penetrating injury at time of SB placement (OR, 24; 95% confidence interval [CI], 2.9 to 200), concurrent pars plana vitrectomy (PPV) (OR, 17.3; 95% CI, 4.9 to 61), diabetes mellitus (DM) (OR, 7.3; 95% CI, 1.8 to 30), prior chronic topical ocular therapy (OR, 4.3; 95% CI, 1.7 to 11), and subsequent ocular procedures (OR, 3.4; 95% CI, 1.5 to 7.5). Factors independently associated with SB removal using multivariate analysis included concurrent globe-penetrating injury (OR, 27.3; 95% CI, 1.7 to 426), concurrent PPV (OR, 11.3; 95% CI, 2.9 to 45), DM (OR, 8.9; 95% CI, 1.3 to 58), and subsequent ocular procedures (OR, 3.9; 95% CI, 1.4 to 11). Factors that did not alter SB removal risk included patient age; gender; and type, size, or location of buckling elements used. CONCLUSIONS Awareness of these risk factors may be valuable for the surgical planning of retinal detachment repair in patients at higher risk for subsequent SB removal and for risk stratification subsequent to SB implantation.
Collapse
|
8
|
Hayashi K, Hayashi H. Influence of phacoemulsification surgery on progression of idiopathic epiretinal membrane. Eye (Lond) 2008; 23:774-9. [PMID: 18535596 DOI: 10.1038/eye.2008.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
9
|
Igarashi C, Hayashi H, Hayashi K. Phacoemulsification after retinal detachment surgery. J Cataract Refract Surg 2004; 30:1412-7. [PMID: 15210216 DOI: 10.1016/j.jcrs.2003.12.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2003] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the outcomes of phacoemulsification in eyes that had previous retinal detachment (RD) surgery. SETTING Hayashi Eye Hospital, Fukuoka, Japan. METHODS Ninety-six eyes of 90 consecutive patients who had phacoemulsification after previous RD surgery (RD group) were included. Fifty-one fellow eyes that had not had RD surgery but did have phacoemulsification served as controls (control group). Recurrence of RD, visual acuity, complications, and the neodymium:YAG (Nd:YAG) laser capsulotomy rate were examined. RESULTS Recurrent RD after phacoemulsification occurred in 2 eyes (2.1%) in the RD group. Three eyes (5.9%) in the control group developed RD postoperatively. The incidence of RD was not significantly different between the 2 groups (P =.3416). The mean final visual acuity in the RD group was 20/30, significantly worse than in the control group (P =.0099). Posterior capsule opacification developed in 29 eyes (30.2%) in the RD group and 11 eyes (21.6%) in the control group; the difference between the groups was not significant. Eighteen eyes (43.9%) that had implantation of a poly(methyl methacrylate) (PMMA) intraocular lens (IOL) and 7 eyes (6.6%) that received an acrylic IOL had an Nd:YAG capsulotomy; the capsulotomy rate was significantly higher in eyes with a PMMA IOL than in eyes with an acrylic IOL (P<.0001). CONCLUSIONS The rate of recurrent RD after phacoemulsification in eyes that had previous RD surgery was similar to that of new occurrence of RD in fellow eyes without RD before phacoemulsification. Because the Nd:YAG capsulotomy rate was lower in eyes with acrylic IOLs than in eyes with PMMA IOLs, acrylic IOLs are recommended for eyes at high risk for RD.
Collapse
Affiliation(s)
- Chizuka Igarashi
- Hayashi Eye Hospital, 4-7-13 Hakataekimae, Hakata-ku, Fukuoka 812-0011, Japan
| | | | | |
Collapse
|
10
|
Assi A, Woodruff S, Gotzaridis E, Bunce C, Sullivan P. Combined phacoemulsification and transpupillary drainage of silicone oil: results and complications. Br J Ophthalmol 2001; 85:942-5. [PMID: 11466251 PMCID: PMC1724059 DOI: 10.1136/bjo.85.8.942] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To review retrospectively 74 consecutive cases of combined phacoemulsification and transpupillary drainage of silicone oil. METHODS Candidate patients for intraocular silicone oil removal and cataract extraction underwent combined phacoemulsification and transpupillary drainage of silicone oil through a planned posterior capsulorrhexis and without the use of a pars plana infusion line. RESULTS The retina remained attached in 59 (79.7%) patients postoperatively. In this success group, the postoperative visual acuity improved in 42 (71.2%) patients. There was no association between age, duration of silicone oil tamponade, preoperative diagnosis, macular status or number and nature of previous surgery, and the incidence of redetachment following silicone oil removal. CONCLUSION Combined phacoemulsification and transpupillary drainage of silicone oil is a safe and reliable technique that offers the main advantage of diminished surgical trauma.
Collapse
Affiliation(s)
- A Assi
- Moorfields Eye Hospital, City Road, London EC1V 2PD, UK.
| | | | | | | | | |
Collapse
|
11
|
Abstract
Many patients require surgery for cataract after retinal surgery. When evaluating patients preoperatively, the surgeon should pay careful attention to the assessment of visual function and potential acuity, and to the slit lamp examination of the lens, posterior capsule, anterior cortical vitreous, and zonules. The surgeon's technique must account for increased nuclear sclerosis, intraoperative miosis, a characteristically longer axial length, and fluctuations in anterior chamber depth from movement of the iris-lens diaphragm. Posterior capsule plaques are not unusual. Posterior capsule opacification is the most frequent late complication. Visual outcomes are usually good except when limited by pre-existing macular pathology. Vision-threatening complications of cataract surgery are unusual.
Collapse
Affiliation(s)
- A S Patel
- Department of Ophthalmology, University of California at Los Angeles School of Medicine, and the Jules Stein Eye Institute, Los Angeles, California 90095, USA
| | | |
Collapse
|
12
|
Flaxel CJ, Mitchell SM, Aylward GW. Visual outcome after silicone oil removal and recurrent retinal detachment repair. Eye (Lond) 2000; 14:834-8. [PMID: 11584838 DOI: 10.1038/eye.2000.232] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Prospective analysis of the effect of removal of silicone oil (ROSO) in eyes with complicated retinal detachments and evaluation of the visual outcome following recurrent retinal detachment after silicone oil removal. METHODS We evaluated 62 consecutive cases of ROSO over a 12 month period. All eyes had previously undergone silicone oil placement for complicated retinal detachments. All eyes undergoing scheduled ROSO over the time period of the study were entered and were reviewed post-operatively. RESULTS Sixty-two eyes were entered into the study. Twenty-one of 62 (34%) developed recurrent retinal detachment following ROSO; 18 of these 21 recurrent detachments were reattached with one additional procedure and only 5 required replacement of the silicone oil. Ten of these 21 eyes (48%) had improvement or stabilisation in final visual acuity compared with the presenting visual acuity. Overall, 39 eyes (63%) had improvement in vision following ROSO and 76% of all eyes had ambulatory visual acuity at the end of the follow-up period. Fourteen eyes required cataract extraction with ROSO to attain this final visual acuity. CONCLUSIONS Overall, ROSO has a significant rate of recurrent retinal detachment, with a high reattachment rate with one additional procedure. Few of these eyes need the silicone oil replaced. Most eyes will retain ambulatory visual acuity even with multiple procedures in cases of complicated retinal detachments following ROSO even with recurrent retinal detachment.
Collapse
|
13
|
Eshete A, Bergwerk KL, Masket S, Miller KM. Phacoemulsification and lens implantation after scleral buckling surgery. Am J Ophthalmol 2000; 129:286-90. [PMID: 10704541 DOI: 10.1016/s0002-9394(99)00352-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine the intraoperative and postoperative complications and best-corrected visual acuity outcomes of eyes undergoing phacoemulsification and intraocular lens implantation after retinal detachment repair by the scleral buckling technique. METHODS The charts of all patients who underwent phacoemulsification and intraocular lens implantation between July 1991 and May 1998 in two surgical practices were reviewed to identify eyes with a history of retinal detachment repaired by the scleral buckling technique. Eyes with a history of pars plana vitrectomy were excluded. Demographic and surgical data, preoperative and postoperative best-corrected visual acuity, and intraoperative and postoperative complications were recorded. RESULTS We identified 34 eyes of 32 patients. The mean interval from retinal detachment repair to phacoemulsification was 12.4 years. The mean interval from phacoemulsification to final examination was 20 months. Risk factors for retinal detachment included isolated myopia (82%), myopia with lattice retinal degeneration (5.9%), and myopia with trauma (8.8%). One eye (2.9%) had no identifiable risk factors. Final best-corrected visual acuity of 20/40 or better was attained in 29 (85%) of 34 eyes and 20/20 or better in 18 (53%) of the eyes. Of the five eyes with the lowest best-corrected visual acuity, three had a macula-off retinal detachment; one had a posterior capsule opacity, epiretinal membrane, and corneal edema secondary to ocular ischemia; and one had advanced glaucoma. All five eyes still experienced an improvement in best-corrected visual acuity. With regard to complications, one eye had a posterior capsular tear with vitreous loss and another developed a postoperative retinal tear. Posterior capsule opacification requiring laser capsulotomy developed in 13 eyes (38%). No eye developed a retinal redetachment. CONCLUSION Phacoemulsification and intraocular lens implantation can be performed safely after scleral buckling surgery and excellent best-corrected visual acuity results can be attained in most eyes. No modification of surgical technique is necessary. No retinal redetachment occurred in this series.
Collapse
Affiliation(s)
- A Eshete
- Department of Ophthalmology, UCLA School of Medicine, Los Angeles, CA 90095-7002, USA
| | | | | | | |
Collapse
|
14
|
Larkin GB, Flaxel CJ, Leaver PK. Phacoemulsification and silicone oil removal through a single corneal incision. Ophthalmology 1998; 105:2023-7. [PMID: 9818600 DOI: 10.1016/s0161-6420(98)91119-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cataracts are a frequent complication after silicone oil infusion for the repair of complicated retinal detachments, occurring in up to 100% of eyes retaining silicone oil for 6 months or more. The authors devised a combined procedure for cataract and silicone oil removal with intraocular lens (IOL) implantation through a single corneal incision and evaluated their results. DESIGN A prospective, noncomparative case series. PARTICIPANTS Thirty-four eyes of 34 consecutive patients with a history of retinal detachment repair requiring silicone oil placement in whom a clinically significant cataract subsequently developed were identified when removal of silicone oil was scheduled. INTERVENTION All 34 eyes were prospectively entered into a study to evaluate the efficacy and potential complications of a combined procedure for cataract and silicone oil removal with posterior chamber lens implantation. All patients underwent uncomplicated phacoemulsification removal of cataract followed by removal of silicone oil and placement of an IOL through a single corneal incision. MAIN OUTCOME MEASURE Recurrent retinal detachment and IOL-related complications were measured. RESULTS Ten eyes had recurrent retinal detachments develop. Final visual acuity ranged from 6/12 to hand movements with 25 eyes (74%) showing stabilized or improved vision. Pre-existing macular pathology and recurrent retinal detachment generally were responsible for poor visual outcome. CONCLUSIONS Combined phacoemulsification, IOL implant with silicone oil removal is a useful procedure in these complicated eyes. Visual outcome generally is good with improvement in visual acuity, even with recurrent retinal detachment or pre-existing macular pathology or both.
Collapse
Affiliation(s)
- G B Larkin
- Moorfields Eye Hospital, Vitreoretinal Unit, London, England
| | | | | |
Collapse
|
15
|
Kang YH, Lee JH. Phacoemulsification and Posterior Chamber Intraocular Lens Implantation After Scleral Buckling, Vitrectomy, or Both. Ophthalmic Surg Lasers Imaging Retina 1998. [DOI: 10.3928/1542-8877-19980101-05] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|