Phacoemulsification and posterior chamber intraocular lens implantation after scleral buckling, vitrectomy, or both

Previous studies have documented the risk of complications for eyes with prior vitreoretinal surgery that later undergo intracapsular or extracapsular cataract extraction. The authors reviewed the records of patients with a history of vitreoretinal surgery and subsequent phacoemulsification to assess the visual outcome in the relatively early postoperative period and to determine the risk of postoperative complications.

The authors identified 21 eyes of 21 patients with a history of scleral buckling, vitrectomy, or both, who subsequently underwent phacoemulsification. Data recorded before, during, and after surgery were reviewed.

The best-corrected visual acuity improved in 20 (95%) of 21 eyes, and the final best-corrected visual acuity was 20/40 or better in 12 (57%) of 21 eyes. The intraoperative complications included iridodialysis, zonular dialysis, and posterior capsular rupture. The immediate postoperative complications were microcorneal edema, anterior chamber hyphema, vitreous hemorrhage, and fibrinous pupillary membrane. No retinal detachments occurred during the postoperative follow-up period, which ranged from 3 to 10 months. Late complications included isolated cases of posterior capsular opacity, herpetic corneal ulcer, and iris posterior synechia; however, the final visual acuities were not limited, except in one eye with a corneal ulcer.

Although some postoperative complications did occur, they did not limit final vision, and useful vision was achieved.