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Abstract

COMBINED PHACOVITRECTOMY IN PRESBYOPIC PATIENTS FOR TREATMENT OF COMPLEX VITREORETINAL DISEASE

MD Mostafa Mahmud, MD Hossam Eldin A. Ziada*, MD Ahmed G. Elmahdy and MD Ahmed N. Elsayed

ABSTRACT

Introduction: Vitrectomy is the standard method used for the treatment of many complications of diabetic retinopathy. However, cataract formation is an inevitable consequence of pars plana vitrectomy especially in presbyopic patients with initial clear lenses either due to the vitrectomy with nuclear sclerosis gradually developing or due to a more immediate gas cataract. Material and methods: Forty eyes of 40 presbyopic diabetic patients with a mean age of 62.4 years, suffering from proliferative diabetic retinopathy, between February 2013 and June 2014, underwent 23 gauge pars plana vitrectomy combined with phacoemulsification and insertion Results: Indication for vitrectomy for the cases in our study were distributed as following:Vitreous hemorrhage in 18 (45%) cases, tractional retinal detachment in 9 (15%) cases, tractional diabetic macular edema in 6 (15%) cases, Pre-macular hemorrhage in 5 (12.5%) cases and Combined tractional and rhegmatogenous retinal detachment in 2 cases. Phacovitrectomy offers several advantages over vitrectomy followed by subsequent cataract surgery. The patient undergoes only a single surgical procedure, yielding a faster overall recovery with rapid visual improvement. With IOL implantation, the patient can enjoy functional unaided vision. However many difficulties and complications have been reported in combined phacovitrectomy procedure which was taken into consideration during our study. Follow up period in our study was ranged from 6 months to 9 months with average follow up period 7.24 months.

Keywords: Phacovitrectomy, vitreoretinal, cataract, capsular opacities.


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