Pars Plana Posterior Capsulectomy during Phacovitrectomy

ABSTRACT

PURPOSE: To evaluate the efficacy and safety of pars plana posterior capsulectomy (PPPC) during phacovitrectomy. METHODS: In this retrospective study, 76 patients (76 eyes) who underwent phacovitrectomy were enrolled. The patients were divided into two groups according to whether PPPC was performed during phacovitrectomy. In group A, PPPC using a vitreous cutter was combined with phacovitrectomy; in group B, only phacovitrectomy was performed. The best-corrected visual acuity (BCVA), predicted and actual refractive errors, adverse events, and posterior capsular opacity (PCO) were analyzed and compared between the two groups. RESULTS: Age, sex, and pre- and postoperative BCVA were not significantly different between group A (n = 37) and group B (n = 39). No intraoperative complications were identified in either group. In group A, the actual refraction (postoperative 2 months) was −0.44 ± 0.88 diopters (D) and a mild hyperopic shift was found compared to the preoperative predicted refraction (−0.56 ± 0.40 D). In group B, the actual refraction was −0.70 ± 0.72 D and a mild myopic shift was found compared to the preoperative predicted refraction (−0.60 ± 0.81 D). The difference in refraction shifts between the two groups was not significant but very close to it (p = 0.050). In group A, yttrium-aluminum-garnet (YAG) laser posterior capsulotomy was not required. However, PCO was observed in 10 eyes in group B, 6 of which subsequently underwent YAG laser posterior capsulotomy at the last follow-up. Lens instability such as dislocation or subluxations was not observed during the follow-up period. CONCLUSIONS: PPPC combined with phacovitrectomy may lead to hyperopic refractive changes. However, this was a safe and effective approach to prevent PCO and additional YAG laser posterior capsulotomy.