Cataract surgery after pars plana vitrectomy

To review recent studies and advances and their possible implications in the care of patients undergoing cataract surgery after pars plana vitrectomy.

Optical biometry has shown to be superior to ultrasound biometry in vitrectomized eyes but still not achieving as good results as it does in nonvitrectomized eyes. Blue light-filter intraocular lenses, with their possible advantage of macular protection, have shown no operative or functional disadvantages in vitrectomized eyes, and thus their routine use can be justified. However, presbyopia-correcting intraocular lenses, at least at their current stage of development, generally, are still not accepted for vitrectomized eyes. Combining cataract surgery with intravitreal injections of bevacizumab or triamcinolone acetonide in patients with macular edema and cataract is advisable to avoid exacerbation of the condition and improve visual outcome. Despite the recent advances, incidences of posterior capsular opacification and retinal detachment are still considerable.

Understanding ocular anatomical alterations imposed by the previous pars plana vitrectomy surgery and the underlying vitreoretinal disease will allow the surgeon to address the special challenges. Despite that, recent advances in techniques and instrumentation have improved the surgical safety and outcomes, reported complications rates are still relatively high.