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A triple procedure: phacoemulsification, intraocular lens implantation, and scleral buckling surgery
Background:
To report the technique and results of simultaneous surgery for cataract and retinal detachment.
Methods:
This retrospective study covered 452 cases of phakic detachment. Dense cataract was present in 15 cases that did not need intravitreal surgery. For these, a triple procedure involving phacoemulsification, posterior chamber lens insertion, and scleral buckling surgery was performed. Combined cataract and scleral buckling surgery was carried out after the failure of initial detachment surgery in four cases, including scleral buckling in three and vitrectomy in one.
Results:
A clear intraoperative view of the fundus was obtained in all cases and retinal breaks were identified in 13. The retina was reattached by combined surgery in 13 cases (87%) and a final acuity of 20/40 or better was attained in 7 of these 13 reattached cases (54%). There was no instance of visual imbalance due to gross miscalculation of intraocular lens power.
Conclusion:
Combined cataract and scleral buckling surgery spares the patient repeat surgery and may improve the outcome by avoiding delay for detachment repair. To perform this procedure, however, vitreoretinal surgeons must be familiar with phacoemulsification techniques.