Abstract
ObjectiveTo evaluate the efficacy and safety of posterior capsulotomy by analyzing the long-term visual outcomes in patients with rhegmatogenous retinal detachment (RD), who underwent combined phaco-vitrectomy with or without primary posterior capsulotomy.MethodsA retrospective longitudinal cohort analysis was performed by using data of rhegmatogenous RD patients undergoing combined phaco-vitrectomy. Patients were divided into two groups; Group A (68 eyes of 68 patients) with capsulotomy, and Group B (39 eyes of 39 patients) without capsulotomy. We reviewed the best-corrected visual acuity (BCVA), incidence of posterior capsule opacification (PCO), clinical features at the diagnosis of rhegmatogenous RD, and intraoperative or postoperative complications following posterior capsulotomy.ResultsThe modified BCVA measured by the logarithm of the minimum angle of resolution at initial diagnosis and 3, 6, and 12 months after surgery was 0.67 in Group A versus 0.85 in Group B (p = 0.258), 0.40 in Group A versus 0.50 in Group B (p = 0.309), 0.27 in Group A versus 0.45 in Group B (p = 0.055), and 0.21 in Group A versus 0.47 in Group B (p = 0.014), respectively. In subgroup with macula-on RRD, Group A exhibited better visual outcomes compared to Group B at 6(0.17 versus 0.40 [p = 0.037]) and at 12 months(0.14 versus 0.39 [p = 0.030]). The incidence of PCO in Group B was higher than Group A(28.2% versus 4.4% (p < 0.001)). There were no complications associated with posterior capsulotomy.ConclusionsA primary posterior capsulotomy during combined phaco-vitrectomy using a 23-gauge vitreous cutter was a safe and effective surgical procedure in patients with RRD patients for preventing postoperative intraocular lens-related PCO.
Highlights
With the advent of modern instrumentation, improved surgical techniques, and improved intraocular lens (IOL), the incidence of posterior capsule opacification has decreased after cataract surgery, but it still remains the most common cause of visual loss.[1, 2] To maximize the visual recovery of outpatients, posterior capsule opacification can be treated with nonsurgical neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy
The modified best-corrected visual acuity (BCVA) measured by the logarithm of the minimum angle of resolution at initial diagnosis and 3, 6, and 12 months after surgery was 0.67 in Group A versus 0.85 in Group B (p = 0.258), 0.40 in Group A versus 0.50 in Group B (p = 0.309), 0.27 in Group A versus 0.45 in Group B (p = 0.055), and 0.21 in Group A versus 0.47 in Group B (p = 0.014), respectively
In subgroup with macula-on RRD, Group A exhibited better visual outcomes compared to Group B at 6(0.17 versus 0.40 [p = 0.037]) and at 12 months(0.14 versus 0.39 [p = 0.030])
Summary
With the advent of modern instrumentation, improved surgical techniques, and improved intraocular lens (IOL), the incidence of posterior capsule opacification has decreased after cataract surgery, but it still remains the most common cause of visual loss.[1, 2] To maximize the visual recovery of outpatients, posterior capsule opacification can be treated with nonsurgical neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy. This procedure is associated with a small risk of complications such as vitreous floaters, a rise in intraocular pressure, macular edema, and damage and decentration of the IOL.[3,4,5,6,7,8]. Several modified techniques have produced successful results, the outcomes are still dependent on the skill of the clinician, so its wider use is still limited.[10,11,12,13]
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