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Related Concept Videos

Open Angle Glaucoma: Treatment01:27

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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: Nov 20, 2025

Author Spotlight: Enhancing Visual Outcomes in Cataract Surgery: A Novel Technique to Prevent Posterior Capsular Opacification Through IOL Rotation
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Combined versus Sequential Phacoemulsification and Pars Plana Vitrectomy: A Meta-Analysis.

Armin Farahvash1, Marko M Popovic2, Arshia Eshtiaghi1

  • 1Faculty of Medicine, University of Toronto, Toronto, Canada.

Ophthalmology. Retina
|January 22, 2021
PubMed
Summary

Combined versus sequential phacoemulsification and pars plana vitrectomy (phaco-PPV) showed no significant differences in visual or refractive outcomes. However, combined surgery had higher risks of synechiae, fibrin, and retinal detachment, but lower risks of posterior capsular tear and macular hole issues.

Keywords:
Cataract surgeryPars plana vitrectomyPhacoemulsificationRetinaRetinal detachment

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Area of Science:

  • Ophthalmology
  • Surgical Techniques

Background:

  • The comparative efficacy and safety of combined versus sequential phacoemulsification and pars plana vitrectomy (phaco-PPV) remain unclear.
  • Understanding these differences is crucial for optimizing surgical strategies and patient outcomes.

Purpose of the Study:

  • To conduct a meta-analysis comparing the efficacy and safety of combined versus sequential phaco-PPV.
  • To evaluate differences in visual acuity, refractive error, and complication rates between the two surgical approaches.

Main Methods:

  • A systematic search of Ovid MEDLINE, EMBASE, and Cochrane CENTRAL was performed for relevant studies.
  • Meta-analysis utilized a random effects model, assessing primary outcomes of best-corrected visual acuity (BCVA) and refractive error, and secondary outcomes including complications.
  • Risk of bias was evaluated using the Cochrane risk of bias tool and ROBINS-I.

Main Results:

  • No significant differences were observed in postoperative BCVA (P=0.76) or mean absolute refractive error (P=0.46) between combined and sequential phaco-PPV.
  • Combined surgery was associated with significantly higher risks of synechiae formation (RR 2.74), fibrin formation (RR 2.81), and retinal detachment (RR 2.65).
  • Conversely, combined surgery demonstrated significantly lower risks of posterior capsular tear (RR 0.43) and macular hole nonclosure/reopening (RR 0.18).

Conclusions:

  • While visual and refractive outcomes are comparable, combined phaco-PPV presents a different safety profile compared to sequential surgery.
  • The findings suggest increased risks for certain complications with combined procedures, alongside a reduced risk for others.
  • Given the reliance on low- to moderate-quality studies, further high-quality randomized controlled trials are warranted to confirm these preliminary conclusions.