Phacoemulsification and foldable intraocular lens implantation combined with vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy.

PURPOSE

To determine the clinical outcomes of phacoemulsification and foldable intraocular lens (IOL) implantation combined with primary vitrectomy and silicone oil tamponade to treat severe proliferative diabetic retinopathy (PDR).

SETTING

Department of Ophthalmology, Seoul National University College of Medicine, and Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.

METHODS

The results of combined cataract surgery and silicone oil injection in 20 eyes (20 patients) were retrospectively analyzed. All patients had tractional or tractional-rhegmatogenous retinal detachment and clinically significant lens opacities; none had previous intraocular surgery. An acrylic foldable IOL was implanted in the capsular bag or ciliary sulcus.

RESULTS

Primary anatomic success was achieved in 90% of eyes. Functional success was attained in 60% of eyes after a mean follow-up of 7.6 months. The postoperative visual acuity improved in 60% of patients, was unchanged in 20%, and was worse in 20%. Silicone oil was removed in 80% of patients without complications after a mean of 3.4 months. The mean absolute value of the difference between the predicted refraction and postoperative refraction was 0.74 diopter (D) (range 0.03 to 1.74 D).

CONCLUSION

Phacoemulsification and foldable IOL implantation combined with primary vitrectomy and silicone oil tamponade was performed safely with favorable anatomic and visual outcomes in eyes with severe PDR.