98th Annual Meeting DOG 2000

K 267

Simultaneous removal of silicone oil via pars plana and cataract operation by phacoemulsification with PCL implantation.

O. Vij¹, A. O. Schüler¹, A. Heiligenhaus², N. Bornfeld¹

Introduction: Formation of advanced lens opacity represents a typical complication after vitrectomy with silicone oil tamponade. Therefore combined operation of silicone oil removal via pars plana and phacoemulsification is carried out more frequent. Aim of our retrospective study was to investigate common intra- and postoperative complications of this procedere.

Methods and patients: Intra- and postoperative course of 47 combined operations was analyzed retrospectively. Silicone oil tamponade was a. o. requiered owing to rhegmatogenous retinal detachment (n = 35), diabetic retinopathy (n = 5), following brachytherapy of choroidal melanoma (n = 3), endophthalmitis (n = 1) and penetrating injury (n = 1). Indication for combined operation was cataract decreasing visual acuity and attached retina without traction. Mean age was 61 ± 13 years, mean follow up was 168 days.

Results: Visual acuity improved in 25 cases, remained unchanged in 10 cases and deteriorated in 12 cases. PCL implantation was performed in 44 cases. Typical intraoperative problems were a. o. marked conjunctival and scleral scars (n = 7), defect of zonular fibers (n = 6), defect of posterior capsule (n = 5), silicone oil in anterior chamber (n = 5) and miosis (n = 5). Typical postoperative complications were a. o. fibrosis of posterior capsule (n = 21), fibrin formation in anterior chamber (n = 13), corneal epithelia defects or edema (n = 13), posterior synechiae (n = 9), increased intraocular pressure (n = 6) and retinal detachment (n = 11). Additional surgery was necessary in 11 cases. In 4 cases intraoperative decision for immediate pars plana vitrectomy was made.

Conclusion: Combined silicone oil removal via pars plana and cataract operation by phacoemulsification shows typical intra- and postoperative complications, particularly direct and operation needing retinal detachment. Combined procedere is safe if specific modifications are applied and practicable with satisfactory results. Visual prognosis is limited by retinal findings.

¹ Center for Ophthalmology, University of Essen, Hufelandstr. 55, 45122 Essen, Germany
² Department for Ophthalmology, St. Franziskushospital, Hohenzollernring 75, 48145 Münster, Germany