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      Risk Factors of Iris Posterior Synechia Formation after Phacovitrectomy with Three-Piece Acrylic IOL or Single-Piece Acrylic IOL

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          Abstract

          Aims: To identify the risk factors of posterior iris synechia formation after phacovitrectomy with posterior chamber single-piece acrylic intraocular lens (IOL; Acrysof® SA60AT) or 3-piece acrylic IOL (Acrysof® MA60BM) implantation. Methods: We selected 153 eyes of 153 patients treated by phacovitrectomy between March 2000 and August 2006 and retrospectively reviewed the relationship between iris posterior synechiae and various factors, such as IOL type, tamponade, preoperative iris posterior synechiae, major indications for surgery, axial length and preoperative anterior chamber (AC) depth. Results: IOL type (p = 0.0447), C<sub>3</sub>F<sub>8</sub> gas tamponades (p = 0.0074), preoperative iris posterior synechiae (p = 0.0001) and postoperative AC fibrin deposition (p = 0.0303) were significantly associated with postoperative iris posterior synechiae by multiple logistic regression analysis. The odds ratio (OR) for single-piece IOL versus 3-piece IOL was 2.658 (95% confidence interval, CI: 1.010–6.993), the OR for C<sub>3</sub>F<sub>8</sub> gas versus balanced salt solution was 4.051 (95% CI: 1.455–11.281), for the presence of preoperative iris posterior synechiae 12.868 (95% CI: 3.511–47.165), and the OR for postoperative AC fibrin deposition was 6.012 (95% CI: 1.186–30.468). Conclusion: Preoperative iris posterior synechiae, C<sub>3</sub>F<sub>8</sub> gas tamponade, postoperative AC fibrin deposition and the single-piece IOL could increase the rates of iris posterior synechiae after phacovitrectomy.

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          Most cited references 7

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          Combining phacoemulsification with pars plana vitrectomy in patients with proliferative diabetic retinopathy: a series of 223 cases.

          To describe the results of combined phacoemulsification, insertion of posterior chamber intraocular lens (PCIOL), and pars plana vitrectomy for patients with retinal disorders resulting from diabetic retinopathy. Retrospective, consecutive, noncomparative, interventional case series. Two hundred twenty-three patients with vitreoretinal disorders secondary to diabetic retinopathy. A case series of 223 consecutive patients with retinal disorders resulting from diabetic retinopathy who underwent combined phacoemulsification, insertion of PCIOL, and pars plana vitrectomy. Vision, number of secondary procedures, and complications. Two hundred twenty-three patients (153 with vitreous hemorrhage, 58 with traction retinal detachment, and 12 with macular traction) underwent combined surgery. The average increase in vision was 4.3 Snellen lines. The average follow-up was 10 months. Retinal detachment occurred in 5% of patients who underwent surgery. Diabetic macular edema was found in 12% after combined surgery. Cystoid macular edema was found in 3%. Vitreous hemorrhage requiring another procedure occurred in 11%. Twenty-two patients (10%) required a repeat vitrectomy (12 for vitreous hemorrhage and 10 for retinal detachment). Combined phacoemulsification, insertion of PCIOL, posterior capsulectomy, and pars plana vitrectomy can be used to treat patients with complications resulting from proliferative diabetic retinopathy. Combined surgery may prevent a second operation for postvitrectomy cataract, allowing earlier visual rehabilitation.
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            Combining phacoemulsification with vitrectomy for treatment of macular holes.

            To describe the results of combined phacoemulsification, insertion of posterior chamber intraocular lens (PCIOL), and pars plana vitrectomy for patients with macular hole. A case series of 89 consecutive patients with macular hole who underwent combined phacoemulsification, insertion of PCIOL, posterior capsulectomy, and pars plana vitrectomy. 80 of 89 patients (89%) had their holes closed with the combined surgery. Four of the nine patients who failed had their holes closed with one further procedure. Of the 89 patients operated on, 61 (65%) had vision of 20/40 or better. Three patients (3%) had Snellen acuity of less than 20/400 postoperatively. Three patients (3%) developed retinal detachments, one with proliferative vitreoretinopathy (PVR). Eight patients (9%) developed CMO. Three patients developed late reopening of their macular holes after remaining closed for 9 months or more. Combined phacoemulsification, insertion of PCIOL, and pars plana vitrectomy surgery can be used to treat macular holes. Combining cataract surgery with vitrectomy surgery may prevent a later second operation for post-vitrectomy cataract formation.
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              Posterior Synechia of the Iris After Combined Pars Plana Vitrectomy, Phacoemulsification, and Intraocular Lens Implantation

               K Shinoda (2001)
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2009
                July 2009
                21 February 2009
                : 223
                : 4
                : 222-227
                Affiliations
                Departments of Ophthalmology, aKorea University Guro Hospital, bKorea University College of Medicine and cKorea University Ansan Hospital, Seoul, Korea
                Article
                203366 Ophthalmologica 2009;223:220–225
                10.1159/000203366
                19246951
                © 2009 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Tables: 3, References: 14, Pages: 6
                Categories
                Original Paper

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