The macula was attached in 27 eyes (37.5%). This information was only available if the notes were obtained.Īll eyes had retinal detachment with posterior vitreous detachment attributed to horseshoe tears (HST) in 52 eyes (72%), atrophic holes in 10 eyes (14%), atrophic holes and HST in 8 eyes (11%), and giant retinal tears in 2 eyes (3%). Thirty-five notes, which had previous PPV for many different retinal procedures, were not obtained and it could not be clarified as to what percentage of these eyes had previous retinal detachment and could potentially be included in the study. Patients who had no follow-up recorded after cataract surgery were excluded ( n=2) and therefore, 72 patients were included in the analysis (32 male and 40 female). In total, 84 notes were obtained and 10 notes were excluded due to additional vitreoretinal procedures at the time of cataract surgery. The case notes of 74 patients who had undergone cataract extraction after retinal detachment surgery by vitrectomy were identified. A corneal suture was used if required to seal the corneal wound at the end of the surgery. An acrylic or silicone lens was inserted into the capsular bag. Cataract surgery was planned to be undertaken as routine phacoemulsification under topical, peribulbar, subTenon, or general anaesthesia. In patients who had had bilateral retinal detachments and cataract extractions, one eye was randomly chosen to be in the study and the fellow eye was excluded. BCVA was converted to the logarithm of minimum angle of resolution (logMAR) scale for statistical analysis. Preoperative and postoperative BCVA were recorded at 3 weeks ( n=72), 6 months ( n=59), and final visit ( n=72). Eyes were excluded if they were undergoing additional vitreoretinal procedures (including removal of silicone oil) at the time of cataract surgery.ĭata collected included patient's demographics, preoperative, and postoperative best-corrected visual acuity (BCVA), intraoperative and postoperative complications. The records of all eyes that had cataract extraction after previous PPV for primary repair of retinal detachment at Moorfields Eye Hospital between 1 December 2002 and 31 September 2003 were reviewed. 1, 14, 15, 16, 17, 18, 19, 20 This study was undertaken to determine the visual outcome and complication profile of eyes undergoing cataract surgery after previous retinal detachment repair by PPV. 1, 14, 15, 16, 17, 18, 19, 20Ĭataract formation occurs in up to 80% of eyes after pars plana vitrectomy (PPV) within 2 years and cataract surgery in the vitrectomised eye presents special challenges, which potentially have higher rates of intraoperative complications. 1, 8, 9, 10, 11, 12, 13 More recently, the results of cataract extraction by phacoemulsification after vitrectomy surgery have reported recurrent retinal detachment rates between 0 and 5.8%.
RETINA REATTACHMENT SURGERY SERIES
Reports of series of eyes that have undergone previous scleral buckling surgery generally document good visual outcomes after cataract surgery, with a low rate of intraoperative complications and recurrent retinal detachment (0–3.4%). 1, 2, 3, 4, 5, 6, 7 The risk for recurrent retinal detachment after cataract surgery in eyes that have previously undergone retinal detachment repair is, however, less well documented. The risk of retinal re-detachment may previously have been underestimated.Ĭataract surgery is known to carry a risk of subsequent retinal detachment which is estimated to be between 0.1 and 0.81%. ConclusionsĬataract extraction after retinal detachment surgery by vitrectomy generally results in a significant visual improvement, however, there is an increased intraoperative and postoperative complication rate. Retinal re-detachment occurred in four eyes (5.6%). Postoperative events occurred in 15 eyes (20.8%). Intraoperative events occurred in nine eyes (12.5%) including capsulorrhexis tears, zonular dehiscence and vitreous loss. Poor vision was usually related to retinal comorbidity. There was a significant improvement in BCVA after cataract extraction ( P<0.001).
Fifty-three eyes (74%) attained 6/12 visual acuity at final follow-up compared with 19 (26%) eyes with a preoperative vision better than 6/12. Resultsīest-corrected visual acuity (BCVA) had improved in 53 (74%) of eyes at 3 weeks after cataract surgery and 65 (90%) at final follow-up. Retrospective analysis of 72 patients who had cataract extraction by phacoemulsification having had retinal detachment repair by vitrectomy and internal tamponade. To determine the intraoperative and postoperative complications and visual outcome of eyes undergoing cataract extraction after previous retinal detachment repair by pars plana vitrectomy (PPV).
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