Comparison of Surgical Result of Vitrectomy vs Combined Phacoemulsification and Vitrectomy in Patients with Diabetic Vitreous Hemorrhage

In eyes with diabetic vitreous hemorrhage, relatively significant improvement of visual acuity has been achieved by vitrectomy.However, visual loss occurs not infrequently due to iris neovascularization or ma, one of the serious complications of vitrectomy for proliferative diabetic retinopathy.We have retrospectively studied the visual acuity and complications in 43 patients (50 eyes)who underwent only vitrectomy (group A)and in 63 patients (64 eyes)who underwent combined phacoemulsification, vitrectomy and posterior chamber intraocular lens (PCL)implantation (group B), from January of 1997 to June of 1999.The age distribution was 30 to 65 years (mean 47 years)in group A and 32 to 78 years (mean 57 years)in group B.The duration of follow up was more than 6 months.The final visual outcome showed the improvement in 84.0%, no change in 6.0%and the worsening in 10.0%in group A and the improvement in 93.7%, no change in 4.7% and the worsening in 1.6%in group B.The iris neovascularization and neovascular glaucoma occurred 10.0%in group A and 4.7%in group B but this difference was not significant statistically (p=0.271).We performed cataract operations in 30%of group A eyes postoperatively.The results of this study suggest that combined phacoemulsification, vitrectomy and PCL implantation are relatively safe and effective procedure for patients with diabetic vitreous hemorrhage.

Combined Surgery of Vitrectomy, Phacoemulsification and Intraocular Lens Implantation in Patients with Vitreous Hemorrhage Caused by Branch Retinal Vein Occlusion Patients

PURPOSE: To evaluate the effect of vitrectomy, phacoemulsification and posterior intraocular lens implantation in patients with branch retinal vein occlusion (BRVO) associated with vitreous hemorrhage. METHODS: We performed vitrectomy, phacoemulsification and posterior intraocular lens implantation in 38 patients with BRVO associated with vitreous hemorrhage. The age distribution was 44 to 82 years old (mean 61.8 years old) and the duration of follow up was 6 to 48 months (mean 16.7 months). Patientswere divided into 3 groups according to intraoperative fundus findings. Patients had only vitreous hemorrhage in group 1, vitreous hemorrhage with fibrovascular proliferations in group 2, and vitreous hemorrhage with retinal breaks in group 3. The number of eyes were 27, 8, and 3 respectively. RESULTS: The improvement of visual acuity up to 2 lines on the chart was found in 37 eyes (97.4%) after the surgery and the final visual acuity of 0.5 or better was achieved in 28 eyes (73.7%). Final corrected visual acuity was 0.5 or better in 85.1% in group 1, in 50.0% in group 2 and in 33.3% in group 3. The percentage of final visual acuity of 0.5 or better was statistically higher in group 1 than goup 2 and group 3 (p=0.036). Only one patient who developed retinal detachment had a decrease of final visual acuity. CONCLUSIONS: The results of this study suggest that combined vitrectomy, phacoemulsification and posterior intraocular lens implantation are relatively effective procedures for patients with BRVO associated with vitreous hemorrhage.