L Grajewski1, O Grajewski2, J Carstens3, L Krause3. 1. Augenklinik, Städtisches Klinikum Dessau, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Brandenburg - Theodor Fontane, Auenweg 38, 06847, Dessau-Roßlau, Deutschland. luise.grajewski@klinikum-dessau.de. 2. , Berlin, Deutschland. 3. Augenklinik, Städtisches Klinikum Dessau, Akademisches Lehrkrankenhaus der Medizinischen Hochschule Brandenburg - Theodor Fontane, Auenweg 38, 06847, Dessau-Roßlau, Deutschland.
Abstract
BACKGROUND: With the surgical methods continuously developed in recent years, macular surgery has become an increasingly less traumatic procedure for the eye. For patients with additional lens opacification, a 1-stage procedure with combined cataract surgery is recommended. OBJECTIVE: The aim of this retrospective study was to record the functional results and complications after elective macular surgery with and without combined phacoemulsification and artificial lens implantation. MATERIAL AND METHODS: The retrospective study included all patients who were operated on with a pars plana vitrectomy (ppV; 25 gauge) for epiretinal membrane, macular hole or vitreoretinal traction between 2010 and 2016 and who had a follow-up period of at least 3 months. The functional results and possible risk factors as well as complications that occurred were then recorded. RESULTS: A total of 781 eyes were identified of which 517 (66%) had a phacoemulsification and artificial lens implantation with a 25-gauge vitrectomy, membranectomy, ILM peeling and SF6 gas or air tamponade. The mean follow-up time was 17 months. The mean logMAR visual acuity was 0.59 preoperatively and 0.4 postoperatively. From 64 phacic eyes which did not receive a combined phacoemulsification and artificial lens implantation 40 (62.5%) required phacoemulsification and artificial lens implantation within 13.6 months due to complicated cataract, 18 even within 6 months. In terms of complications, there were comparable results between ppV alone and the combined operation, particularly with respect to an IOL dislocation or iris capture. CONCLUSION: Overall elective macular surgery is a procedure with few complications both without and above all with combined phacoemulsification and artificial lens implantation. Therefore, a combined operation makes sense in terms of surgical management and postoperative rehabilitation, especially in times of a pandemic with limited surgical resources.
BACKGROUND: With the surgical methods continuously developed in recent years, macular surgery has become an increasingly less traumatic procedure for the eye. For patients with additional lens opacification, a 1-stage procedure with combined cataract surgery is recommended. OBJECTIVE: The aim of this retrospective study was to record the functional results and complications after elective macular surgery with and without combined phacoemulsification and artificial lens implantation. MATERIAL AND METHODS: The retrospective study included all patients who were operated on with a pars plana vitrectomy (ppV; 25 gauge) for epiretinal membrane, macular hole or vitreoretinal traction between 2010 and 2016 and who had a follow-up period of at least 3 months. The functional results and possible risk factors as well as complications that occurred were then recorded. RESULTS: A total of 781 eyes were identified of which 517 (66%) had a phacoemulsification and artificial lens implantation with a 25-gauge vitrectomy, membranectomy, ILM peeling and SF6 gas or air tamponade. The mean follow-up time was 17 months. The mean logMAR visual acuity was 0.59 preoperatively and 0.4 postoperatively. From 64 phacic eyes which did not receive a combined phacoemulsification and artificial lens implantation 40 (62.5%) required phacoemulsification and artificial lens implantation within 13.6 months due to complicated cataract, 18 even within 6 months. In terms of complications, there were comparable results between ppV alone and the combined operation, particularly with respect to an IOL dislocation or iris capture. CONCLUSION: Overall elective macular surgery is a procedure with few complications both without and above all with combined phacoemulsification and artificial lens implantation. Therefore, a combined operation makes sense in terms of surgical management and postoperative rehabilitation, especially in times of a pandemic with limited surgical resources.
Authors: Alexander D Port; John G Nolan; Nicole H Siegel; Xuejing Chen; Steven D Ness; Manju L Subramanian Journal: Graefes Arch Clin Exp Ophthalmol Date: 2020-08-19 Impact factor: 3.117
Authors: Anna-Maria Demetriades; John D Gottsch; Robert Thomsen; Amr Azab; Walter J Stark; Peter A Campochiaro; Eugene de Juan; Julia A Haller Journal: Am J Ophthalmol Date: 2003-03 Impact factor: 5.258
Authors: Lars-Olof Hattenbach; Peter Heinz; Nicolas Feltgen; Hans Hoerauf; Thomas Kohnen; Siegfried Priglinger; Werner Bachmann; Johannes Rieks; Nicole Eter; Thomas Reinhard Journal: Ophthalmologe Date: 2020-08-26 Impact factor: 1.059