J Korean Ophthalmol Soc.  2015 May;56(5):709-714. 10.3341/jkos.2015.56.5.709.

Postoperative Refractive Errors after Posterior Capsulectomy during Combined Vitrectomy and Cataract Surgery

• Kim JH
• Han SB
• Lee SJ
• Kim MS

• KMID: 2121168
• DOI: http://doi.org/10.3341/jkos.2015.56.5.709

Abstract

PURPOSE
To evaluate the difference between the predicted and actual postoperative refractions after combined vitrectomy and cataract surgeries with a posterior capsulectomy.
METHODS
We performed a retrospective study of 33 eyes of 33 patients who underwent combined vitrectomy and cataract surgeries in our hospital between March 2013 and May 2014. The patients were divided into 2 groups: those who underwent a posterior capsulectomy (group A) and those who underwent combined vitrectomy and cataract surgeries (group B). The actual refractive errors were analyzed 3 months after surgery using spherical equivalent. We compared the results between the predicted and actual refractive errors in the two groups.
RESULTS
Group A consisted of 25 eyes of 25 patients and group B of 8 eyes of 8 patients. In group A, the average difference between predicted and actual postoperative refractive errors was -0.16 +/- 0.38 D (p = 0.083). The predicted refraction was -0.33 +/- 0.46 D and actual refraction was -0.49 +/- 0.55 D in group A. There was no statistically significant difference between the predicted refraction and actual refractive errors in group A (p = 0.083). In group B, the average difference between predicted and actual postoperative refractive errors was 0.27 +/- 0.29 D (p = 0.078). Additionally, the predicted refraction was -0.49 +/- 0.77 D and actual refraction was -0.22 +/- 0.59 D. The difference between the predicted refraction and actual refractive errors in group B was not statistically significant (p = 0.078).
CONCLUSIONS
When a posterior capsulectomy is performed during combined vitrectomy and cataract surgery, no significant difference in refractive errors between the predicted refraction and actual refractive errors was observed 3 months after surgery. Compared with combined vitrectomy and cataract surgeries only, a small amount of myopic refractive change tended to occur 3 months after surgery.

Keyword

Cataract surgery; Intraocular lens; Posterior capsulectomy; Refraction; Vitrectomy

MeSH Terms

Cataract*
Humans
Lenses, Intraocular
Refractive Errors*
Retrospective Studies
Vitrectomy*

Reference

References

1. Heimann H, Bartz-Schmidt KU, Bornfeld N, et al. Scleral buckling versus primary vitrectomy in rhegmatogenous retinal detachment: a prospective randomized multicenter clinical study. Ophthalmology. 2007; 114:2142–54.

2. Han NS, Lee SB, Kim YB, Jo YJ. Results of triple surgery: cataract extraction, intraocular lens implantation and vitrectomy for retinal detachment. J Korean Ophthalmol Soc. 2004; 45:2041–6.

3. Misra A, Burton RL. Incidence of intraoperative complications during phacoemulsification in vitrectomized and nonvitrectomized eyes: prospective study. J Cataract Refract Surg. 2005; 31:1011–4.

4. Biró Z, Kovacs B. Results of cataract surgery in previously vitrectomized eyes. J Cataract Refract Surg. 2002; 28:1003–6.

5. Tan JC, Spalton DJ, Arden GB. The effect of neodymium: YAG capsulotomy on contrast sensitivity and the evaluation of methods for its assessment. Ophthalmology. 1999; 106:703–9.

6. Magno BV, Datiles MB, Lasa MS, et al. Evaluation of visual function following neodymium:YAG laser posterior capsulotomy. Ophthalmology. 1997; 104:1287–93.

7. Weiblinger RP. Review of the clinical literature on the use of the Nd:YAG laser for posterior capsulotomy. J Cataract Refract Surg. 1986; 12:162–70.

8. Gimbel HV, Neuhann T. Development, advantages, and methods of the continuous circular capsulorhexis technique. J Cataract Refract Surg. 1990; 16:31–7.

9. Gimbel HV. Posterior continuous curvilinear capsulorhexis and optic capture of the intraocular lens to prevent secondary opacification in pediatric cataract surgery. J Cataract Refract Surg. 1997; 23(Suppl 1):652–6.

10. Galand A, van Cauwenberge F, Moosavi J. Posterior capsulorhexis in adult eyes with intact and clear capsules. J Cataract Refract Surg. 1996; 22:458–61.

11. Thornval P, Naeser K. Refraction and anterior chamber depth before and after neodymium: YAG laser treatment for posterior capsule opacification in pseudophakic eyes: a prospective study. J Cataract Refract Surg. 1995; 21:457–60.

12. Findl O, Drexler W, Menapace R, et al. Changes in intraocular lens position after neodymium: YAG capsulotomy. J Cataract Refract Surg. 1999; 25:659–62.

13. Hu CY, Woung LC, Wang MC, Jian JH. Influence of laser posterior capsulotomy on anterior chamber depth, refraction, and intraocular pressure. J Cataract Refract Surg. 2000; 26:1183–9.

14. Blankenship GW. Stability of pars plana vitrectomy results for diabetic retinopathy complications. A comparison of five-year and six-month postvitrectomy findings. Arch Ophthalmol. 1981; 99:1009–12.

15. Kim JW, Yang JW, Jee DH. Stability of four-haptic intraocular lens in combined phacoemulsification and vitrectomy. J Korean Ophthalmol Soc. 2010; 51:829–34.

16. Hutton WL, Pesicka GA, Fuller DG. Cataract extraction in the diabetic eye after vitrectomy. Am J Ophthalmol. 1987; 104:1–4.

17. Kim EY, Ahn JH, Lew HM, Yang HS. Effect of vitrectomy on IOL calculation for cataract surgery : study of vitrectomized eyes. J Korean Ophthalmol Soc. 2008; 49:1759–64.

18. Kappelhof JP, Vrensen GF. The pathology of after-cataract. A minireview. Acta Ophthalmol. (Suppl):1992; 13–24.

19. McDonnell PJ, Zarbin MA, Green WR. Posterior capsule opacification in pseudophakic eyes. Ophthalmology. 1983; 90:1548–53.

20. Steinert RF, Puliafito CA, Kumar SR, et al. Cystoid macular edema, retinal detachment, and glaucoma after Nd:YAG laser posterior capsulotomy. Am J Ophthalmol. 1991; 112:373–80.

21. Stark WJ, Worthen D, Holladay JT, Murray G. Neodymium: YAG lasers. An FDA report. Ophthalmology. 1985; 92:209–12.

22. Bath PE, Fankhauser F. Long-term results of Nd:YAG laser posterior capsulotomy with the Swiss laser. J Cataract Refract Surg. 1986; 12:150–3.

23. Kumagai K, Ogino N, Shinjo U, et al. Vitreous opacification after neodymium:YAG posterior capsulotomy. J Cataract Refract Surg. 1999; 25:981–4.

24. Lewis H, Singer TR, Hanscom TA, Straatsma BR. A prospective study of cystoid macular edema after neodymium: YAG laser posterior capsulotomy. Ophthalmology. 1987; 94:478–82.

25. Park SE, Lee SJ. Mechanized posterior capsulectomy during combined vitrectomy and cataract surgery. J Korean Ophthalmol Soc. 2007; 48:1335–40.

26. Ohrloff C, Schalnus R, Rothe R, Spitznas M. Role of the posterior capsule in the aqueous-vitreous barrier in aphakic and pseudophakic eyes. J Cataract Refract Surg. 1990; 16:198–201.

27. Weinreb RN, Wasserstrom JP, Parker W. Neovascular glaucoma following neodymium-YAG laser posterior capsulotomy. Arch Ophthalmol. 1986; 104:730–1.

28. Poliner LS, Christianson DJ, Escoffery RF, et al. Neovascular glaucoma after intracapsular and extracapsular cataract extraction in diabetic patients. Am J Ophthalmol. 1985; 100:637–43.

29. Yang X, Zou L, Binrong M, et al. Tensile strength of lens capsules in eye-bank eyes. J Cataract Refract Surg. 1998; 24:543–6.

30. Suzuki Y, Sakuraba T, Mizutani H, et al. Postoperative refractive error after simultaneous vitrectomy and cataract surgery. Ophthalmic Surg Lasers. 2000; 31:271–5.

31. Paik JS, Ku HC, Lee YC, Kim HS. The change in ACD and refraction after Nd:YAG laser posterior capsulotomy. J Korean Ophthalmol Soc. 2006; 47:905–12.