Clément Auchère Lavayssiere1, Anne-Laure Lux2, Guillaume Beraud3, Alice Degoumois2, Christian Billotte2, Éric Denion4. 1. CHU de Caen, Department of Ophthalmology, Caen, France; Université Caen Normandie, Medical School, Caen, France. Electronic address: auc.clement@gmail.com. 2. CHU de Caen, Department of Ophthalmology, Caen, France; Université Caen Normandie, Medical School, Caen, France. 3. Médecine Interne et Maladies Infectieuses, CHU de Poitiers, Poitiers, France; Université Droit et Santé Lille 2, Lille, France; Interuniversity Institute for Biostatistics and statistical Bioinformatics, Hasselt University, Hasselt, Belgium. 4. CHU de Caen, Department of Ophthalmology, Caen, France; Centre Ophtalmologique du Pays des Olonnes, Olonne-sur-Mer, France; INSERM, U 1075 COMETE, Pôle de formation et de recherche en santé, Caen, France.
Abstract
PURPOSE: To compare the rate of posterior synechiae of the iris (PSI) occurrence after phacovitrectomy between a group with lens-in-the-bag (LIB) implantation, that is, implantation in the capsular bag, and a group with bag-in-the-lens (BIL) implantation. SETTING: CHU de Caen, Department of Ophthalmology, Caen, France. DESIGN: Comparative retrospective study. METHODS: One hundred consecutive cases of phacovitrectomies conducted between May 2013 and July 2016 were included. A retrospective analysis of the occurrence rate of PSI in the LIB group and in the BIL group was performed, using multivariate analysis including multiple risk factors such as preoperative synechiae, proliferative diabetic retinopathy, use of 20-gauge vitrectomy, use of gas or silicone tamponade, and use of endophotocoagulation. RESULTS: One hundred eyes of 92 patients were included in this study (55 eyes in the LIB group and 45 in the BIL group). The occurrence of PSI was significantly lower in the BIL group with 1 case (2%) versus 22 cases (40%) in the LIB group (P < .001). Among the risk factors studied, preoperative synechiae and the use of retinal endophotocoagulation were almost significantly associated with the occurrence of PSI (P = .068 and P = .087, respectively). In the LIB group, these PSI led to 1 case of acute elevation of intraocular pressure by pupillary seclusion and the use of laser iridotomy in 8 cases. CONCLUSION: The use of BIL rather than LIB implantation in phacovitrectomy practically eliminates PSI.
PURPOSE: To compare the rate of posterior synechiae of the iris (PSI) occurrence after phacovitrectomy between a group with lens-in-the-bag (LIB) implantation, that is, implantation in the capsular bag, and a group with bag-in-the-lens (BIL) implantation. SETTING:CHU de Caen, Department of Ophthalmology, Caen, France. DESIGN: Comparative retrospective study. METHODS: One hundred consecutive cases of phacovitrectomies conducted between May 2013 and July 2016 were included. A retrospective analysis of the occurrence rate of PSI in the LIB group and in the BIL group was performed, using multivariate analysis including multiple risk factors such as preoperative synechiae, proliferative diabetic retinopathy, use of 20-gauge vitrectomy, use of gas or silicone tamponade, and use of endophotocoagulation. RESULTS: One hundred eyes of 92 patients were included in this study (55 eyes in the LIB group and 45 in the BIL group). The occurrence of PSI was significantly lower in the BIL group with 1 case (2%) versus 22 cases (40%) in the LIB group (P < .001). Among the risk factors studied, preoperative synechiae and the use of retinal endophotocoagulation were almost significantly associated with the occurrence of PSI (P = .068 and P = .087, respectively). In the LIB group, these PSI led to 1 case of acute elevation of intraocular pressure by pupillary seclusion and the use of laser iridotomy in 8 cases. CONCLUSION: The use of BIL rather than LIB implantation in phacovitrectomy practically eliminates PSI.