Combined cataract surgery and vitrectomy for recurrent retinal detachment

Purpose: To report our experience with combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in the ma nagement of recurrent retinal detachment (RD) and visually significant cata ract. Methods: Retrospective chart review of patients with cataract and recurrent RD who underwent combined cataract extraction, posterior chamber intraocul ar lens implantation, and pars plana vitrectomy between January 1991 and Se ptember 1998 at the Bascom Palmer Eye Institute. Sixteen eyes were included . All eyes had visually significant cataract and had undergone primary repa ir of the RD with encircling scleral buckle; eight eyes also had undergone pars plana vitrectomy during the primary repair. The technique of cataract extraction included phacoemulsification (10 eyes), extracapsular cataract e xtraction (5 eyes), and pars plana lensectomy (1 eye). All eyes underwent p ars plana vitrectomy, membrane peeling, fluid-air exchange, endolaser treat ment, and placement of a retinal tamponade. Perfluoropropane (C3F8) gas was used in 14 eyes, and silicone oil was placed in two eyes. Results: The postoperative follow-up interval ranged from 4 to 64 months (m ean, 16 months). Preoperative visual acuity ranged from 20/60 to hand motio ns and was better than 20/200 in 3 (19%) eyes. Postoperatively, 9 (56%) eye s improved to better than 20/200. Anatomic success was achieved after the i nitial reoperation in 13 (81%) eyes. With further surgery, the overall succ ess rate was 94%. Conclusions: Combined cataract surgery, posterior chamber intraocular lens implantation, and pars plana vitrectomy in selected patients with cataract and recurrent RD was successful in improving visual acuity and achieving re tinal reattachment in most of these reoperated patients.