Efficacy of phacovitrectomy combined with internal limiting membrane peeling for macular diseases

To observe the efficacy of vitrectomy with internal limiting membrane (ILM) peeling combined with phacoemulsification with intraocular lens (IOL) implantation in the treatment of cataract with co-existing macular diseases.

A total of 28 cataract patients (28 eyes) with co-existing macular diseases were admitted to Aier Eye Hospital between May 2008 and May 2011. The clinical characteristics were analyzed in this study. Subjects included 6 men and 22 women, aged from 56 to 77 years (mean 64 years), with duration of disease ranging from 2 to 36 months (mean 9.3 months). All patients underwent phacoemulsification with implantation of a hydrophobic acrylic IOL into the capsular bag and pars plana vitrectomy with ILM peeling.

Postoperatively, patients underwent 3- to 18-months of follow-up (mean 7.2 months). Only one eye had macular hole failing to close. Normal macular structure was restored in the other 27 eyes. The presenting visual acuity and best corrected visual acuity (BCVA) did not differ significantly (t=-1.724, P=0.096), with the BCVA in 27 eyes (96.4%) improving by 2 lines or more. The improvement in minimum angle of resolution (MAR) was > 0.3 in 21 eyes, ≥ 0.1 in 6 eyes and < 0.1 in 1 eye. The mean spherical equivalent (SE) was -4.67±5.98D preoperatively and -0.38±0.69D postoperatively (t=4.157, P＜0.005).

Combined phacovitrectomy surgery is a reliable and safe procedure in the treatment of cataract complicated by macular disease.