Pars plana vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy

[Objective] To evaluate the effectiveness and safety of combined pars plana vitrectomy (PPV) and phacoemulsification (PEA) with intraocular lens (IOL) implantation in patients with concomitant cataract and proliferative diabetic retinopathy (PDR). [Method] This retrospective study consisted of 46 eyes of 36 patients with proliferative diabetic retinopathy and clinically significant lens opacities. Pars plana vitrectomy was combined with phacoemulsification and intraocular lens implantation ;Gas tamponade was employed in 15 eyes; Silicone oil tamponade was employed in 4 eyes; Postoperative Visual acuity, and complications was analyzed. [Result] The postoperative follow-up interval ranged from 3 to 24 months (mean, 6 months). The postoperative visual acuity improved in 74% of patients, was unchanged in 15%, and was worse in 11%. Diabetic macular abnormalities present to eyes with low visual acuity. Postoperative complications included posterior synechia of the iris in 17 eyes (35%), and retinal detachment in 3 eyes (8%), opacification of the posterior capsule in 12 eyes (26%), delayed corneal epithelial healing12 eyes(26%), vitreous hemorrhage 14 eyes (30%). [Conclusion] This study suggests that the combined operation of PPV, PEA, and IOL implantation is safe and effective for PDR coexisting with cataract. Combined surgery may prevent a second operation for postvitrectomy cataract, allowing earlier visual rehabilitation. Diabetic macular abnormalities is main reason preventing visual acuity raising.