Phacoemulsification Cataract Surgery in Vitrectomized Eyes

Purpose: To determine the problems, safety, and results of phacoemulsification cataract surgery in previously vitrectomized eyes.

Setting: Department of Ophthalmology of Galdácano Hospital, Galdacano, Spain.

Methods: In this prospective study, phacoemulsification was performed in 23 eyes that had had vitrectomy between February 1992 and May 1994. Surgical and postsurgical difficulties and complications and visual acuity results were analyzed. Follow-up ranged from 12 to 24 months.

Results: The incidence of surgical problems and complications was higher than usual: 7 eyes presented small pupil size (< 3.0 mm); sudden changes in anterior chamber depth and pupil size during surgery occurred in 6 eyes; unusual mobility and flaccidity of the posterior capsule was observed in 6 cases, which was associated with posterior subcapsular cataract and young age (< 50 years); posterior capsule tear occurred in 2 eyes, 1 of which required anterior vitrectomy. Postoperatively, best visual acuity improved two Snellen lines or more in 17 eyes (73.91%), did not change in 3 (13.04%), and worsened in 3.

Conclusion: Phacoemulsification in vitrectomized eyes presented more problems and complications than usual. However, it seems to be safer than manual extracapsular surgery because it minimized the risk of intraoperative eye hypotony or collapse.