J Korean Ophthalmol Soc.  2019 Feb;60(2):152-159. 10.3341/jkos.2019.60.2.152.

Pars Plana Posterior Capsulectomy during Phacovitrectomy

• Lee SJ
• Kim YC

• KMID: 2438074
• DOI: http://doi.org/10.3341/jkos.2019.60.2.152

Abstract

PURPOSE
To evaluate the efficacy and safety of pars plana posterior capsulectomy (PPPC) during phacovitrectomy.
METHODS
In this retrospective study, 76 patients (76 eyes) who underwent phacovitrectomy were enrolled. The patients were divided into two groups according to whether PPPC was performed during phacovitrectomy. In group A, PPPC using a vitreous cutter was combined with phacovitrectomy; in group B, only phacovitrectomy was performed. The best-corrected visual acuity (BCVA), predicted and actual refractive errors, adverse events, and posterior capsular opacity (PCO) were analyzed and compared between the two groups.
RESULTS
Age, sex, and pre- and postoperative BCVA were not significantly different between group A (n = 37) and group B (n = 39). No intraoperative complications were identified in either group. In group A, the actual refraction (postoperative 2 months) was −0.44 ± 0.88 diopters (D) and a mild hyperopic shift was found compared to the preoperative predicted refraction (−0.56 ± 0.40 D). In group B, the actual refraction was −0.70 ± 0.72 D and a mild myopic shift was found compared to the preoperative predicted refraction (−0.60 ± 0.81 D). The difference in refraction shifts between the two groups was not significant but very close to it (p = 0.050). In group A, yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was not required. However, PCO was observed in 10 eyes in group B, 6 of which subsequently underwent YAG laser posterior capsulotomy at the last follow-up. Lens instability such as dislocation or subluxations was not observed during the follow-up period.
CONCLUSIONS
PPPC combined with phacovitrectomy may lead to hyperopic refractive changes. However, this was a safe and effective approach to prevent PCO and additional YAG laser posterior capsulotomy.

Keyword

Capsule opacification; Phacoemulsification; Vitrectomy

MeSH Terms

Capsule Opacification
Dislocations
Follow-Up Studies
Humans
Intraoperative Complications
Lasers, Solid-State
Phacoemulsification
Posterior Capsulotomy
Refractive Errors
Retrospective Studies
Visual Acuity
Vitrectomy

Figure

• 

  Figure 1 Slit lamp photographs of postoperative follow-up in each group. (A) Clear posterior capsulectomy margin (black arrowhead) two days after phacovitrectomy with pars plana posterior capsulectomy (group A). (B) Posterior capsule after yttrium-aluminum-garne laser capsulotomy at 12 months after combined vitrectomy and cataract surgery without posterior capsulectomy (group B). White arrows indicate lens epithelial cells on growth.

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