Phacoemulsification and lens implantation after scleral buckling surgery

PURPOSE: To determine the intraoperative and postoperative complications an d best-corrected visual acuity outcomes of eyes undergoing phacoemulsificat ion and intraocular lens implantation after retinal detachment repair by th e scleral buckling technique. METHODS: The charts of all patients who underwent phacoemulsification and i ntraocular lens implantation between July 1991 and May 1998 in two surgical practices were reviewed to identify eyes with a history of retinal detachm ent repaired by the scleral buckling technique. Eyes with a history of pars plana vitrectomy were excluded. Demographic and surgical data, preoperativ e and postoperative best-corrected visual acuity, and intraoperative and po stoperative complications were recorded. RESULTS: We identified 34 eyes of 32 patients. The mean interval from retin al detachment repair to phacoemulsification was 12.4 years. The mean interv al from phacoemulsification to final examination was 20 months. Risk factor s for retinal detachment included isolated myopia (82%), myopia with lattic e retinal degeneration (5.9%), and myopia with trauma (8.8%). One eye (2.9% ) had no identifiable risk factors. Final best-corrected visual acuity of 2 0/40 or better was attained in 29 (85%) of 34 eyes and 20/20 or better in 1 8 (53%) of the eyes, Of the five eyes with the lowest best-corrected visual acuity, three had a macula-off retinal detachment; one had a posterior cap sule opacity, epiretinal membrane, and corneal edema secondary to ocular is chemia; and one had advanced glaucoma. All five eyes still experienced an i mprovement in best-corrected visual acuity, With regard to complications, o ne eye had a posterior capsular tear with vitreous loss and another develop ed a postoperative retinal tear. Posterior capsule opacification requiring laser capsulotomy developed in 13 eyes (38%), No eye developed a retinal re detachment, CONCLUSION: Phacoemulsification and intraocular lens implantation can be pe rformed safely after scleral buckling surgery and excellent best-corrected visual acuity results can be attained in most eyes, No modification of surg ical technique is necessary. No retinal redetachment occurred in this serie s. (C) 2000 by Elsevier Science Inc. All rights reserved.