Łączone zabiegi fakoemulsyfikacji z wszczepieniem soczewki wewnątrzgałkowej oraz witrektomii przez pars plana w leczeniu współistniejącej zaćmy oraz zaawansowanej proliferacyjnej retinopatii cukrzycowej
Combined Phacoemulsification Procedures with Intraocular Lens Implantation and Pars Plana Vitrectomy for Coexisting Cataract and Severe Proliferative Diabetic Retinopathy Management
Michał Wilczyński, Wojciech Omulecki, Olena Wilczyńska
Klinika Chorób Oczu Uniwersytetu Medycznego w Łodzi
Kierownik: dr hab. n. med., prof. nadzw. Wojciech Omulecki
Summary: Purpose: The purpose of the paper was to analyze indications and clinical outcomes of combined phacoemulsification and pars plana vitrectomy performed in coexisting cataract and complications of severe proliferative diabetic retinopathy, which developed in the course of type 2 diabetes mellitus.
Methods: The examined group consisted of non-randomized, consecutive series of all diabetic patients who underwent combined phacoemulsification and primary pars plana vitrectomy in the years 2001-2004 in the Department of Ophthalmology Medical University of Łódź, Poland. The data were gathered retrospectively from medical records of these patients.
The examined group consisted of 26 eyes of 26 patients, including 15 women (57.7%) and 11 men (42.3%) aged from 26 to 75 years. All patients had clinically significant cataract and severe proliferative diabetic retinopathy which was a complication of type 2 diabetes mellitus.
Results: In the examined group no intraoperative complications were observed. Minor transient early postoperative complications were found in 26.92% of eyes. Full primary therapeutic anatomic success was achieved in 88.46% of eyes. There was no deterioration in terms of anatomic state in any of the patients. Improvement in visual acuity was observed in 73.08% of eyes, unchanged visual acuity in 23.08% and decreased visual acuity in 3.85% of eyes, respectively.
Conclusions: The data from this study suggest that procedure combining pars plana vitrectomy for proliferative diabetic retinopathy with phacoemulsification and intraocular lens implantation is safe. It allows clear intraoperative visualization of the posterior pole, enables to avoid the second procedure and ensures good early postoperative results both in terms of anatomy and visual acuity and is a good alternative to these operations performed separately.
Keywords: phacoemulsification, cataract, diabetic retinopathy, vitrectomy, combined surgery.