Журнал клинической и экспериментальной офтальмологии
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Phacoemulsification on Previously Vitrectomized Eyes

Mohammed Riani, Taoufiq Abdellaoui, Said Chatoui, Karim Reda, Abdelbarre Oubaaz, Yassine Abaloun

Purpose: To evaluate the patient characteristics and to determine the factors affecting the development time and type of cataract occurring after pars plana vitrectomy (PPV) as well as the possible difficulties and/or complications encountered during and after this cataract surgery by phacoemulsification.

Setting: Department of Ophthalmology, Military hospital of instruction Mohammed V, Rabat, Morocco.

Methods: It is a monocentric retrospective study of 35 eyes previously vitrectomized and having been operated cataract between January 2013 and December 2015.

Results: The mean patient age was 57 years. The etiology of the PPV (p=0.136), and the type of tamponade used (p=0.305) had no statistically significant effect on the type of cataract. The median interval between PPV and phacoemulsification was 11,2 months and there was no statistically significant difference in this interval in relation to age (inferior or superior than 50 years) (p=0.485), presence of diabetes (p=0.236), scleral buckling (p=0.72), etiology of vitrectomy (p=0.46) or the type of tomponade used (p=0.449). The main operational difficulty was the deep fluctuating anterior chamber (70%). Intraoperative complications included a capsulorhexis leak (5.7%), posterior capsular rupture (11.4%), zonular dialysis (2.85%) and dropped nucleus (2.85%). In postoperative, the most frequent complication was posterior capsule opacification, the other complications appear to be no more frequent and significant than on a non-vitrectomized eye.

Conclusion: Cataract surgery after PPV is a challenge that requires special considerations from the cataract surgeon. To avoid intraoperative complications, the operator must know the different traps of this procedure and adapt his surgical technique.