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PubMedDate not supplied

Vitrectomy for diabetic macular edema: effect of glycemic control (HbA(1c)), renal function (creatinine) and other local factors.

AIMS: To determine the effect of preoperative factors on the foveal thickness following vitrectomy for diabetic macular edema. METHODS: Fifty-eight eyes of 47 patients underwent vitrectomy for diabetic macular edema. In all eyes, no clear, visible vitreomacular traction was present. Twelve eyes were pseudophakic before vitrectomy, and 31 eyes underwent concurrent phacoemulsification and intraocular lens (IOL) implantation. Multiple logistic regression analysis was used to assess the independent effect of age, history of photocoagulation, diabetic retinopathy status, preoperative posterior vitreous detachment, HbA(1c) and serum creatinine levels within 2 weeks before surgery, lens status after surgery and follow-up period on the foveal thickness determined by optical coherence tomography. RESULTS: The median preoperative visual acuity was 20/100 (range from 20/500 to 20/20), and the median postoperative visual acuity was 20/70 (range from 20/500 to 20/13). The preoperative visual acuity (logarithm of minimal angle of resolution; logMAR) was 0.73 +/- 0.36 (mean +/- SD; 20/107 Snellen acuity), and the mean postoperative logMAR visual acuity was 0.60 +/- 0.39 (20/80), which was significantly better than the mean preoperative value (Wilcoxon signed rank test, p = 0.011). The mean +/- SD of preoperative foveal thickness was 475.9 +/- 172.5 micrometer, and the mean postoperative foveal thickness was 277.3 +/- 171.9 micrometer. The mean postoperative foveal thickness was significantly thinner than the preoperative thickness (Student's paired t test, p < 0.0001). Multiple logistic regression analysis showed that a preoperative low HbA(1c) and postoperative pseudophakia were independently associated with the decrease in foveal thickness (p = 0.01, p = 0.04, respectively). CONCLUSIONS: The greater reduction in foveal thickness in eyes with an IOL probably resulted from a relatively larger amount of vitreous being removed during the vitrectomy. Because the decrease in foveal thickness may be related to the preoperative glycemic control and the amount of vitreous, these factors should be considered in the planning for vitrectomy.

Adult↗

PubMed2003

Management of vitreous loss during cataract surgery under topical anesthesia with transconjunctival vitrectomy system.

PURPOSE: A new technique to manage posterior capsular rupture with vitreous prolapse into the anterior chamber during phacoemulsification under topical anesthesia using the sutureless self-sealing 25-gauge transconjuctival vitrectomy system. METHOD: In the event of vitreous prolapse into the anterior chamber, the corneal wound is sutured and cleared of vitreous. A trans conjunctival 25-gauge sclerotomy through the pars plana is made. The high speed 25-guage trans-conjunctival vitrectomy system (TVS-25) under topical anesthesia is introduced and vitrectomy is performed to clear the anterior chamber of vitreous. An anterior vitrectomy is also done. A foldable intraocular lens is subsequently inserted. RESULTS: The vitrectomy is performed in a closed chamber maintaining normal intraocular pressure. The high-speed cutter exerts minimal traction on the vitreous. The accessibility to vitreous improves through the pars plana route ensuring more complete removal of the vitreous and restoration of normal anatomy. Topical anesthesia avoids the risks of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. CONCLUSIONS: The 25-gauge pars plana incision is small and self-sealing. This makes the procedure fast, effective, painless and safe.

Anesthesia, Local↗

PubMedDate not supplied

Vitrectomy results for diffuse diabetic macular edema with and without inner limiting membrane removal.

PURPOSE: To determine whether vitrectomy for diffuse diabetic macular edema with and without internal limiting membrane (ILM) peeling is equally effective in reducing edema. METHODS: The authors retrospectively analyzed the surgical outcomes in 73 eyes of 52 patients with diffuse diabetic macular edema. Eighteen eyes (Group A) underwent three-port pars plana vitrectomy with posterior hyaloid membrane (PHM) removal, while 55 eyes (Group B) had pars plana vitrectomy with additional ILM peeling after PHM removal. RESULTS: Intraoperatively, the posterior hyaloid was found to be attached to the macula in all eyes. In Group A, macular edema resolved completely in 8 eyes (44.4%) with improvement of visual acuity (VA). In Group B, VA improved in 38 eyes (69.1%) with complete resolution of edema. The results of this study indicated that vitrectomy effectively reduced macular edema but eyes with ILM peeling (Group B) presented better results than those without ILM peeling. Another important factor related to the outcome seems to be the level of glycosylated hemoglobin (HbA1c). CONCLUSIONS: In eyes with diffuse diabetic macular edema vitrectomy seems to be effective, but additional ILM peeling presented better results.

Aged↗

PubMed1990

Ocular inflammatory activity following different techniques of lens extraction and vitrectomy in rabbits.

The ocular inflammatory activity following different techniques of lens extraction and vitrectomy was studied in rabbits recovered from primary uveitis. Primary uveitis was induced by intravitreal injection of human serum albumin. After five to ten weeks, when the eyes were completely quiet, vitrectomy combined with lensectomy in one session or extracapsular lens extraction followed by vitrectomy was performed in different groups of rabbits. The most intense postoperative inflammatory process was encountered following removal of the lens independently of the route of extraction (via the ciliary body or via the anterior chamber). Vitrectomy via the ciliary body led to a minimal postoperative inflammation which resolved within 7 days. From these results we concluded that vitrectomy in primarily sensitized rabbit eyes can be performed without intense postoperative complications.

Animals↗

PubMed1999

Non-diabetic and non-oculotraumatic vitreous haemorrhage treated by pars plana vitrectomy.

BACKGROUND: Until the advent of pars plana vitrectomy, no efficient treatment for non-resorbing vitreous haemorrhage was at hand. Especially if the cause of the vitreous haemorrhage was not known, such as in most cases of non-diabetic and non-oculotraumatic vitreous haemorrhage, a lot of time often was lost by waiting for the resorption, because of the lack of any effective treatment modality. METHODS: All the cases (126) of non-diabetic and non-oculotraumatic vitreous haemorrhage treated with a pars plana vitrectomy for non-resorbing vitreous bleeding during a 15-year period were studied. Both the aetiology of the haemorrhage as well as the functional results have been tabulated. Except for the cases with a retinal detachment or a suspected retinal tear that were operated on immediately, 6 months were waited upon for spontaneous clearing. RESULTS: One third of these haemorrhages was due to vascular lesions (32.5%), one third to "rhegmatogenous" disordes [retinal tears with (25.5%) or without (8%) retinal detachment and one third to a group of various diseases (13.5%)]. In this last group Terson syndrome (5.5%), age-related macular degeneration (13.5%) and presumed posterior vitreous detachment (12%) were most numerous. Functional results mainly depend upon the underlying cause of the vitreous haemorrhage. Visual acuity ranged from 20/40-20/20 in 100% of cases of Terson syndrome and posterior vitreous detachment, 80% of retinal tears, 27% of vascular disorders and 25% of retinal detachments. Vision below 20/400 was obtained in 76% of age-related macular degenerations, 51% of vascular lesions, 50% of retinal detachments and 10% of retinal tears. CONCLUSION: Non-oculotraumatic and non-diabetic vitreous haemorrhages can be caused by a wide variety of diseases. If there is no tendency to spontaneous clearing a pars plana vitrectomy can be helpful by restoring visual function and by allowing treatment of the underlying disease in some cases. Most indications for vitrectomy are not urgent and one can wait for spontaneous clearing of the vitreous for about 6 months but with respect to retinal tears with or without retinal detachment no time should be lost. In these cases the vitrectomy should be done at once.

Diabetes Complications↗

PubMed1999

[Pars plana vitrectomy in the treatment of endophthalmitis].

PURPOSE: To assess the effectiveness of vitrectomy in the treatment of patients with endophthalmitis. MATERIAL AND METHODS: Ten patients with endophthalmitis were qualified for treatment with vitrectomy via pars plana of a cilliary body. Endophthalmitis was diagnosed as resulting from previous: ECCE + I in 3 patients, penetrating bulb injury in 3 patients, penetrating keratoplasty in 1 patient; 3 other patients suffered from endogenous endophthalmitis. In all patients prior to surgical procedure samples of the vitreous were collected for bacteriology and mycology tests. RESULTS: In 9 cases the surgery was followed by intravitreal administration of 1 or 2 antibiotics. In 1 case an antibiotic was added to the infusion solution. In all patients the following data were analyzed together with the result of a surgical procedure: cause of endophthalmitis, visual acquity directly before and after the procedure and over the follow-up period (from 6 months to 3 years), time delay between the onset of endophthalmitis and vitrectomy performed. CONCLUSION: Vitrectomy performed via pars plana of a cilliary body is an effective method of treatment in cases of endophthalmitis. In patients with endophthalmitis early performed vitrectomy, followed by adequate adjuvant pharmacotherapy determine the chances for good postoperative prognosis.

Adult↗

PubMed2000

[Comparison of scleral buckling and vitrectomy for superior retinal detachment caused by flap tears].

PURPOSE: We compared the surgical results of vitrectomy and scleral buckling for uncomplicated superior retinal detachment caused by flap tears. SUBJECTS AND METHODS: Included in the study were 225 phakic eyes of 225 patients undergoing primary surgery from January 1990 to December of 1996 for superior retinal detachment caused by flap tears; all eyes had been followed for longer than six months after surgery. The choice of procedures was based on each surgeon's preference. The cases were evaluated retrospectively and the surgical outcome and the rate of complications compared between the two groups of eyes. RESULTS: Initial and final anatomical success rate were 92% and 100% after each procedure. Redetachment after the first procedure was due to new retinal breaks in 5 eyes, reopening of original breaks in 2 eyes of vitrectomy cases, and malpositioned buckle in 11 eyes of scleral buckling cases. Proliferative vitreoretinopathy occurred in 3 eyes of vitrectomy cases. CONCLUSION: Primary vitrectomy was as successful as scleral buckling for superior rhegmatogenous retinal detachment. Although a high incidence of postoperative cataract formation was a major drawback, vitrectomy had some advantages over to scleral buckling.

Adult↗

PubMed2000

[Final visual acuity in patients undergoing posterior vitrectomy for Terson's syndrome: a series of 11 cases].

PURPOSE: The purpose of this study was to assess visual acuity after vitrectomy for Terson's syndrome. METHODS: This is a retrospective study of 11 eyes (7 patients), who underwent pars plana vitrectomy between 1996 and 1998. Visual acuity was evaluated at 1, 5 and 12 months. We also report immediate and delayed complications. RESULTS: Initial visual acuity was below 20/200 for 9 patients (81%). Final visual acuity was 20/25. An epiretinal membrane was noticed in two patients during the surgical procedure. Final visual acuity for those two patients was only 20/40 and 20/100. Two patients developed cataract following vitrectomy, one developed an endophthalmitis with good vision recovery. CONCLUSION: Vitrectomy for vitreous hemorrhage in Terson's syndrome after three months follow up is a solution without major risks and has a good visual prognosis. Final visual acuity of patients after vitrectomy for Terson's syndrome is good. However, Terson's complications such as epiretinal membrane and cataract are limiting factors for good visual recovery.

Adult↗

PubMed2000

Combined cataract surgery and vitrectomy for recurrent retinal detachment.

PURPOSE: To report our experience with combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in the management of recurrent retinal detachment (RD) and visually significant cataract. METHODS: Retrospective chart review of patients with cataract and recurrent RD who underwent combined cataract extraction, posterior chamber intraocular lens implantation, and pars plana vitrectomy between January 1991 and September 1998 at the Bascom Palmer Eye Institute. Sixteen eyes were included. All eyes had visually significant cataract and had undergone primary repair of the RD with encircling scleral buckle; eight eyes also had undergone pars plana vitrectomy during the primary repair. The technique of cataract extraction included phacoemulsification (10 eyes), extracapsular cataract extraction (5 eyes), and pars plana lensectomy (1 eye). All eyes underwent pars plana vitrectomy, membrane peeling, fluid-air exchange, endolaser treatment, and placement of a retinal tamponade. Perfluoropropane (C3F8) gas was used in 14 eyes, and silicone oil was placed in two eyes. RESULTS: The postoperative follow-up interval ranged from 4 to 64 months (mean, 16 months). Preoperative visual acuity ranged from 20/60 to hand motions and was better than 20/200 in 3 (19%) eyes. Postoperatively, 9 (56%) eyes improved to better than 20/200. Anatomic success was achieved after the initial reoperation in 13 (81 %) eyes. With further surgery, the overall success rate was 94%. CONCLUSIONS: Combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in selected patients with cataract and recurrent RD was successful in improving visual acuity and achieving retinal reattachment in most of these reoperated patients.

Adult↗

PubMed2000

Retinal damage by air infusion during vitrectomy in rabbit eyes.

PURPOSE: Visual field defects after vitrectomy can be seen after any surgery involving fluid-air exchange. To elucidate the effect during surgery of the infused air on the retina, the present study investigated the changes in the morphology of the rabbit retina induced by air infusion and the changes resulting from varying amounts of infused air pressure. METHODS: Eighteen eyes of 18 rabbits were used. A standard three-port vitrectomy with artificial posterior vitreous detachment followed by fluid-air exchange was performed in 12 eyes. During the fluid-air exchange, humidified air was infused with an air pressure of 25 or 40 mm Hg for 30 seconds. As a control, vitrectomy without fluid-air exchange was performed in six eyes. The eyes were enucleated and fixed immediately. Specimens were processed and examined by light and scanning electron microscopy (SEM). RESULTS: With SEM, sharply demarcated retinal lesions were observed at the opposite side from the infusion cannula in all eyes in which a fluid-air exchange was performed. At the lesion, the internal limiting membrane was often detached, and the underlying nerve fiber layer was exposed. Light microscopy revealed that the inner retina was most affected, with concomitant swelling of the inner plexiform layer and the inner granular layer. In addition, the retina was often focally detached with adhesion of some retinal pigment epithelial cells to the photoreceptor cells. Increased infused air pressure was accompanied by a significant increase in the area of retinal damage. In contrast, no morphologic change was observed in the control eyes. CONCLUSIONS: Air infusion during vitrectomy can cause mechanical retinal damage in the rabbit retina. The mechanical damage may result in a visual field defect after vitrectomy.

Air↗

PubMed1997

Vitrectomy for complicated Eales disease.

PURPOSE: We determined the efficacy of pars plana vitrectomy in a series of patients with complicated Eales disease. METHODS: Clinical records were reviewed on 47 consecutive patients (49 eyes) who underwent vitrectomy for persistent vitreous hemorrhage (PVH) and/or traction retinal detachment (TRD) with neovascular membranes (NVM). All cases were divided into 4 subgroups of eyes with PVH (without obvious NVM, n = 9), NVD (NVM from the optic disc, n = 10), NVP (peripheral NVM, n = 11), or ENV (extensive NVM and logn-standing TRD, n = 17). RESULTS: The study included 8 women and 39 men with a mean age of 27.3 years (range, 16 to 50 years). The visual acuity was light perception in 15 eyes, hand motions in 18 eyes, counting fingers in 6 eyes and 0.02 to 0.1 in 10 eyes before vitrectomy. Visual acuity improved postoperatively in all eyes with PVH, NVD of NVP with a mean visual acuity of 0.32 (range, 0.05 to 1.0, n = 28) except 3 eyes unchanged. There was no significant difference (P > 0.05) in the patient age, preoperative visual acuity, or visual improvement after vitrectomy among these 3 subgroups. In the eyes with ENV, however, postoperative visual improvement was obtained but limited in 9 eyes (range, 0.02 to 0.15). Visual acuity was unchanged in 9 eyes. There was a significant difference (P < 0.01) in postoperative visual acuity between the eyes with ENV and the eyes with PVH, NVD or NVP. CONCLUSIONS: Vitrectomy with removal of persistent vitreous hemorrhage and focal neovascular membranes and endolaser photocoagulation may lead to improved visual acuity in the majority of eyes with Eales disease. However, extensive fibrovascular membranes and long-standing retinal detachment result in poor visual outcome. Earlier surgery can be considered to prevent visual loss in the patients.

Adolescent↗

PubMed2002

[Vitrectomy in treatment of idiopathic and secondary pre-retinal fibrosis].

PURPOSE: To present the results of vitrectomy in the management of preretinal fibrosis. MATERIAL AND METHODS: 45 patients with preretinal fibrosis treated with vitrectomy were analysed. 33 of them were treated from 1997 to 1998 in Ophthalmology Dept. University of Heidelberg (Germany) and 12 were treated from 1998 to 1999 in the 1st Eye Hospital Lublin University School of Medicine. The reason for preretinal fibrosis: idiopathic-22 patients, retinal detachment--16, retinal vein occlusion--2, trauma--2, uveitis-1, perivasculitis--1, alopecia--1. RESULTS: Due to applied treatment 27 patients (60%) showed visual improvement, 13 patients (29%) had the same visual acuity before and after vitrectomy and 5 patients (11%) noticed a decrease of visual acuity after the treatment. CONCLUSIONS: Vitrectomy is an effective method of treatment of patients with preretinal fibrosis. In cases with no improvement of visual acuity after surgery, vitrectomy could reduce a metamorphopsia.

Adolescent↗

PubMed2002

[Posterior vitrectomy for dislocated nuclear fragments during phakoemulsification: incidence, risk factors and prognosis of postoperative retinal detachment].

INTRODUCTION: Dislocated nuclear fragments during phakoemulsification are a well-known complication. The treatment is often surgical, and serious complications, among which a retinal detachment may occur. The purpose of this study was to evaluate its incidence, risk factors, and prognosis. METHODS: This retrospective study included a consecutive series of 24 eyes undergoing posterior vitrectomy for dislocated nuclear fragments during phakoemulsification. The main outcome measures were the postoperative retinal detachment (incidence, risk factors, prognosis). RESULTS: Two retinal detachments occurred after vitrectomy, an incidence of 8%. In both cases, a significant inflammation of the anterior chamber and corneal decompensation were noted before vitrectomy. More than 50% of the nucleus was dislocated. Intraocular implant manipulation did not intervene in either case. Two tears occurred during vitrectomy in one case. The prognosis of the detachment, with proliferation, was poor in both cases. DISCUSSION: and conclusion: The high incidence of retinal detachment compares with that observed after phakoemulsification complicated by vitreous loss. Anterior segment deterioration, which compromises posterior segment visualization, and dislocation of more than 50% of the nucleus, that increases the risk of fragments falling on the retina during vitrectomy, may increase the occurrence of retinal detachment with a poor prognosis because of periretinal proliferation.

Adolescent↗

PubMed2002

[Vitrectomy for pseudophakic cystoid macular edema].

PURPOSE: To evaluate the effect of vitrectomy for pseudophakic cystoid macular edema(CME). PATIENTS AND METHODS: This study included 34 eyes of 31 patients that underwent vitrectomy for CME after intraocular lens(IOL) surgery without complications. CME was diagnosed by slit-lamp biomicroscopy with contact lens. Visual acuity and CME status were evaluated preoperatively and postoperatively. The interval between IOL surgery and vitrectomy was from 1 to 52 months, with an average of 11 months. Vitreous gel was beneath the iris in all cases, and there was no adhesion to the anterior segment. Preoperative visual acuity ranged from 0.1 to 0.9, with an average of 0.44. RESULTS: CME was resolved postoperatively in all cases. Resolution period ranged from 1 to 12 months, with an average of 2.6 months. Visual acuity improved postoperatively and ranged from 0.1 to 1.2, with an average of 0.84. The factors related to postoperative visual acuity were IOL-CME interval, preoperative visual acuity, and the period of CME resolution. The factor related to the period of CME resolution was preoperative visual acuity. CONCLUSION: After vitrectomy for CME after IOL surgery without complications, CME resolves quickly and visual acuity improves. Early vitrectomy has good visual results.

Aged↗

PubMedDate not supplied

Retrospective analysis of vitrectomy with and without internal limiting membrane peeling for stage 3 and 4 macular hole.

BACKGROUND AND OBJECTIVE: To evaluate the efficacy and safety of pars plana vitrectomy with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling versus pars plana vitrectomy without ILM peeling for stage 3 and 4 primary idiopathic macular hole. PATIENTS AND METHODS: Sixty-two eyes of 60 consecutive patients with idiopathic macular hole underwent vitrectomy with gas (C3F8) injection. The first 46 eyes underwent vitrectomy without ILM peeling; of these, 14 had epiretinal membrane peeling and were excluded, leaving 32 eyes (no ILM group). The remaining 16 eyes underwent vitrectomy with ICG-assisted ILM peeling (ICG-ILM group). Follow-up data at 6 to 48 months postoperatively were recorded and analyzed. RESULTS: Macular hole closure was achieved in 13 (81%) of 16 patients in the ICG-ILM group and 16 (50%) of 32 patients in the no ILM group (P = .036). Analysis of the data from eyes with closed holes indicates that the ICG-ILM group achieved a better mean final visual acuity compared with the no ILM group (20/60 vs 20/100, respectively) (P = .017). No complications were attributed to the use of ICG. CONCLUSIONS: ICG-assisted ILM peeling significantly increased the rate of hole closure in eyes with stage 3 or 4 idiopathic macular hole. The use of ICG did not adversely affect the visual acuity results, and it appears to be a safe adjunct to macular hole surgery.

Aged↗

PubMedDate not supplied

Comparison of phacoemulsification and planned extracapsular cataract extraction in combined pars plana vitrectomy and posterior chamber intraocular lens implantation.

BACKGROUND AND OBJECTIVE: To compare two kinds of cataract removal methods combined with pars plana vitrectomy and posterior chamber intraocular lens (PC-IOL) implantation. PATIENTS AND METHODS: Cataract removal was performed by either phacoemulsification or extracapsular cataract extraction (ECCE) and followed by pars plana vitrectomy and PC-IOL implantation. Between May 1996 and June 2001, 31 and 22 patients with cataract and vitreoretinal disease were treated by phacoemulsification and ECCE, respectively, combined with pars plana vitrectomy and PC-IOL implantation. Preoperative demographic data and postoperative vision, astigmatism change, and complications were analyzed. RESULTS: The mean age of patients in the phacoemulsification and ECCE groups was 62.5 and 63.4 years, respectively. Diabetes mellitus was the most common underlying disease resulting in vitreous opacity. Vision improved in 87.1% of the phacoemulsification group and 59.1% of the ECCE group. The change in astigmatism after surgery was 0.92+/-1.08 D (P = .001) in the ECCE group and 0.25+/-0.74 D (P = .087) in the phacoemulsification group. There were fewer postoperative complications, including recurrent vitreous hemorrhage, increased intraocular pressure, and iris changes in the phacoemulsification group than in the ECCE group. CONCLUSION: Phacoemulsification and ECCE combined with pars plana vitrectomy and PC-IOL implantation are both effective surgical methods to achieve better and more rapid visual rehabilitation for patients with combined cataract and vitreoretinal disease. In this study, phacoemulsification combined with pars plana vitrectomy and PC-IOL implantation resulted in greater improvement in vision, less astigmatism change, and fewer postoperative complications.

Aged↗

PubMed2005

[Intraocular pressure values following vitrectomy with silicone oil tamponade].

Secondary glaucoma is a relatively common complication after pars plana vitrectomy and silicone oil injection for repair of complex retinal detachment. The aim of this study was to evaluate the influence of silicone oil tamponade on intraocular pressure elevation and to identify the mechanism of this elevation. The study included 45 eyes of 45 patients who had undergone pars plana vitrectomy and silicone oil tamponade for repair of complex retinal detachment. Ophthalmic examination was performed before vitrectomy, and one and six months after vitrectomy. The increase in intraocular pressure was measured one month postoperatively in 37.77% of patients. The mechanism of intraocular pressure increase was silicone oil emulsification in 52.98%, closure of Ando's iridectomy in 23.54%, and idiopathic angle closure glaucoma in 23.54% of patients with elevated intraocular pressure. After silicone oil removal, elevated intraocular pressure persisted in 7 (15.55%) patients; in 5 patients it was controlled medically, while two patients underwent glaucoma surgery. Six months postoperatively 3 patients developed secondary neovascular glaucoma due to the prolipherative ischemic disease. Elevation of intraocular pressure following vitrectomy with silicone oil tamponade had a temporary effect, as it did not lead to permament intraocular pressure elevation but regressed after silicone oil removal from the eye.

Glaucoma↗

PubMed2005

[Evaluation of results of combined pars plana vitrectomy and cataract removal].

PURPOSE: Cataract often coexists with pathologies of the vitreous body. Moreover, after several months after vitrectomy, the lens becomes opaque. Lens opacities interfere with appropriate visualisation of the vitreous chamber and the eye fundus, which makes performing vitreoretinal procedures difficult. For this reason, in such patients, a combined procedure of pars plana vitrectomy and cataract extraction can be considered. This is retrospective analysis of the indications and results of combined cataract extraction and pars plana vitrectomy. MATERIAL AND METHODS: The data were based on case histories of patients who underwent combined cataract extraction and pars plana vitrectomy in the years 2001 - 2003, in the Department of Ophthalmology, Medical University of Lódź. The evaluated data included: diagnosis, pre- and postoperative best corrected visual acuity, intraocular pressure, pre- and postoperative state of the anterior and posterior segment of the eye and the employed surgical techniques. RESULTS: The examined group consisted of 40 patients (40 eyes), including 20 men and 20 women, at the age from 13 to 76 years old (mean 55.7, SD+/-14.6). The indications to vitrectomy were: vitreous haemorrhage, retinal detachment, vitreoretinal proliferations, intraocular foreign body, persistent hyaloid artery and endophthalmitis. Phacoemulsification was the most often used method of cataract extraction (34 people, 85%). In three patients cataract was removed by classical extracapsular cataract extraction (ECCE), and in further 3 patients bimanual aspiration was used. In terms of anatomical results, therapeutic success was achieved in 35 cases (87,5%). Improvement of visual acuity was observed in 28 people (70%), unchanged visual acuity in 10 people (25%), and a decrease in visual acuity in 2 patients (5%). Improvement of visual acuity at least 2 lines on Snellen's chart was achieved in 20 patients (50%).

Adolescent↗