A Clinical Research On Combined Surgeries Of Anterior And Posterior Ocular Segments

Objective:To evaluate the effectiveness and safety of pars plana vitrectomy combined with phacoemulsification and intraocular lens(IOL) implantation in the treatment of complicated vitreoretinal diseases and cataract. To study the effectiveness and safety of secondary implantation of intraocular lens(IOL) after lensetomy and pars plana vitrectomy.Methods:1. We retrospectively reviewed the medical results of 23 eyes(23 cases)with complicated vitreoretinal diseases and cataract which were performed pars plana vitrectomy combined with phacoemulsification and intraocular lens(IOL) implantation from July 2002 to January 2006. Preoperative and postoperative visual acuity and complications are recorded.2. We retrospectively reviewed the medical results of the patients with lensetomy and pars plana vitrectomy from March 2002 to January 2007. After frequent clinical follow-up, we selected 13 eyes (13 cases) with firmly reattached retina by indirect ophthalmoscopy and obviously improved corrected visions. Preoperative and postoperative visual acuity and complications are recorded.Results:1.Pre-BCVA0.4-HM/30cm(0.02±0.08),Post-BCVA0.8-0.02(0.2±0.24),The post-BCVA was better than the pre-BCVA in varying degrees, 47.83%(11/23) improves obviously. Postoperative complications include corneal bedewing in 6 eyes, corneal epithelium edema in 2 eyes, anterior chamber effusion in 3 eyes, intraocular hypertension in 6 eyes, macula flava preretinal membrane in 1 eye, iridic local opisthosynechia in 3 eyes, IOL incarceration in 2 eyes, recurrent retinal detachment in 2 eyes. After corresponding treatment, the complications above were healed.2. Pre-BCVA 0.1-HM/10cm( 0.03±0.03) , Post-BCVA 0.8-0.1(0.4±0.24), the Post-BCVA was better than the Pre-BCVA in varying degrees, 100%(13/13) improved obviously. Postoperative complications include corneal bedewing in 2 eyes, anterior chamber effusion in 1 eye, intraocular hypertension in 1 eye. After corresponding treatment, the complications above were healed.Conclusion:1. The combined surgery is a safe and effective approach to treat complicated vitreoretinal diseases and cataract. Strict operating indications and experienced operative skills are crucial in selected cases. By selective homeochronous intraocular lens implantation, patients can quickly improve their visual acuity, and avoid the damage and complications from the secondary intraocular lens implantation.2. Secondary implantation of IOL after lensetomy and pars plana vitrectomy has better selectivity and prediction.Strict operating indications and experienced operative skills are crucial to the safety and outcome of the surgery.