Phacoemulsification combined with pars plana vitrectomy for eyes with cataract and proliferative diabetic retinopathy

Objective To evaluate the clinical results of phacoemulsification combined with pars plana vitrectomy for eyes with cataract and proliferative diabetic retinopathy. Design Non-controlled retrospective case series study. Participants 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Methods Phacoemulsification,posterior chamber intraocular lens (PCIOL) implantation combined with pars plana vitrectomy were done in 123 eyes with proliferative diabetic retinopathy (PDR) and cataract. Postoperative vision,number of secondary procedures and surgical complications were analyzed. Main Outcome Measures Postoperative visual improvement and associated complications. Results All 123 eyes underwent combined surgery. The average follow-up was 10 months. 99 eyes (81%) experienced postoperative vision improvement of varying degrees. Vision improved by 2 lines or more in 93 eyes (76%). No apparent corneal edema or corneal decompensation were encountered. One patient with type 1 diabetes developed neovascular glaucoma 6 months after surgery. Retinal detachment occurred in 1 eye and reoperated. Vitreous hemorrhage requiring secondary procedure happened in 4 eyes. All 24 eyes (19%) without vision improvement were found to be with diabetic maculopathy. Conclusions Phacoemulsification combined with pars plana vitrectomy can be used as an effective surgical tool to improve visions in patients with PDR and cataract. Diabetic maculopathy is the major cause of poor visual improvement. (Ophthalmol CHN ,2006,15: 198-201)