Clinical Observation Of Phase ?/? IOL Implantation In The Silicone Oil Tamponade Pars Plana Vitrectomy Combined With Phacoemulsification

Objective:To evaluate the safety and efficacy of phase I/II IOL implantation in the silicone oil tamponade pars plana vitrectomy combined with phacoemulsification,and provide evidence-based medical evidence for the choice of the right time of IOL implantation.Methods:Retrospective analysis of medical records of phase ?/? IOL implantation in the silicone oil tamponade pars plana vitrectomy combined with phacoemulsification in our hospital between January 2015 and January 2017 were studied.phase ? IOL implantation group had 36 patients(36 eyes),20 males and 16 females,aged 45 to 81 years old,mean 61±9.63 years old.There were 16 patients(16 eyes)in phase ? IOL implantation group,9 males and 7 females,the age was 56-78 years old(mean,62 ± 7.69 years old).The preoperative and postoperative visual acuity and postoperative complications were recorded and analyzed.Statistical analysis was performed using the Pearson chi-square test to compare the data between two groups.Results:1,The patients with phase ?/? IOL implantation in the silicone oil tamponade pars plana vitrectomy combined with phacoemulsification were received silicone oil removal and silicone oil removal combined with Phase II IOL implantation respectively after 3 to 12 months(mean 7.5 ± 2.11 m),4 to 8 months(mean 6.07±1.48 m).Then the patients were followed up between 6 and 27 months(mean 11.14 ± 4.93m).2,10 cases of phase I IOL implantation group and 12 cases of phase ? IOL implantation group had postoperative best corrected visual acuity(Post-BCVA)improved separetely.The Post-BCVA between two groups has statistically significant difference(?2 = 10.1,p<0.05).Phase ? IOL implantation group had better improved Post-BCVA.3,Postoperative complications:The phase ?/? IOL implantation silicone oil tamponade pars plana vitrectomy combined with phacoemulsification:16 cases in phase ? IOL implantation group and 9 cases in phase ?IOL implantation group showed no complications.The complications between two groups had no statistically significant difference(?2=0.62,p>0.05).The complications in phase ? IOL implantation group and in phase ? IOL implantation group were as below respectively:transient intraocular pressure rise were 9 cases and 4 cases(?2 =0.12,p>0.05),7 cases and 3 cases corneal edema(?2=0.1,p>0.05),4 cases and 1 case fibrinous exudation in the anterior chamber(?2=0.002,p>0.05),3 cases and 2 cases silicone oil efflux into the anterior chamber(?2=0.002,p>0.05),4 cases and 2 cases secondary intraocular pressure rise(?2=0.11,p>0.05),both 3 cases iris synichia(?2=0.96,p>0.05),4 cases and 2 cases posterior capsule opacity(?2=0.11,p>0.05).The incidence of complications between the two groups had no statistically significant difference.Silicone oil removal:26 cases in phase ? IOL implantation group and 10 cases in phase ?IOL implantation group showed no complications,The complications between two groups had no statistically significant difference(x2=0.14,p>0.05).The complications in phase ? IOL implantation group and in phase ? IOL implantation group were as below respectively:transient intraocular pressure rise were 6 cases and 3 cases(?2=0.08,p>0.05),5 cases and 3 cases corneal edema(?2=0.12,p>0.05),3 cases and 1 case fibrinous exudation in the anterior chamber(?2=0.27,p>0.05).1 case in phase I IOL implantation group occured recurrent retinal detachment after silicone oil removal.The complications between the two groups had not statistically significant differences.Conclusion:1,The recovery of visual acuity after phase ?/? IOL implantation silicone oil tamponade pars plana vitrectomy combined with phacoemulsification was associated with the preoperative retinal condition and severity of vitreoretinal diseases.2,Regardless of the right time of IOL implantation,the occurrence of postoperative complications of phase ?/? IOL implantation silicone oil tamponade pars plana vitrectomy combined with phacoemulsification was associated with the kind of vitreoretinal diseases and surgical procedure.3,Both phase ? and phase ? IOL implantation silicone oil tamponade pars plana vitrectomy combined with phacoemulsification were safe and effective methods for the treatment of complex vitreoretinal diseases coexisting cataract.