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Session Title: Complex Cases and Surgery
Session Date/Time: Monday 07/10/2013 | 14:30-16:00
Paper Time: 15:33
Venue: Forum (Ground Floor)
First Author: : A.El Nady EGYPT
Co Author(s): : T. Sarhan
to compare the visual outcome and complications for viterectomy alone versus vitrectomy combined with phacoemulsification and IOL implantation in the manegement of DIABETIC VITREOUS HEMORRHAGE
Zagazig university hospital
In this study, we compared vitrectomy alone and vitrectomy combined with phacoemulsification and IOL implantation with regard to both complications and visual results. This is a prospective comparative case study comprised of 24 eyes from 24 patients who underwent pars plana vitrectomy for diabetic vitreous hemorrhage (VH) with or without tractional retinal detachment (TRD). Pars plana vitrectomy was done for 12 eyes (12 patients) and combined Pars plana vitrectomy, phacoemulsification and intraocular lens implantation was done for 12 eyes (12 patients). Postoperative evaluation included best corrected visual acuity, postoperative complications including transient increased intraocular pressure, macular edema, hyphema and recurrent vitreous hemorrhage.
In the vitrectomy alone group, 9 (75%) eyes had a final vision improvement of one or more lines. In the phacovitrectomy group, 11 (91.6%) eyes had a final vision improvement of one or more lines. There was significantly better vision improvement in the phacovitrectomy group. 9 of 12 (75%) eyes in the vitrectomy alone group showed significant cataract progression postoperatively. Postoperative recurrent VH was found in two eyes (16.6%) in the vitrectomy alone group and in no eyes (0%) in the phacovitrectomy group. The incidence was significantly lower in the phacovitrectomy group (p<0.05). Other complications included postoperative transient IOP elevation, glaucoma, macular edema and hyphema; there were no significant differences between the two groups for these complications.
Sutureless 23G vitrectomy combined with phacoemulsification and IOL implantation yields more satisfactory visual results.
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