Short-term outcomes of combined pars plana vitrectomy for epiretinal membrane and phacoemulsification surgery with multifocal intraocular lens implantation

• Published in: Clinical ophthalmology (Auckland, N.Z.) Vol. 13; pp. 723 - 730
• Main Authors: Patel, Sunny B, Snyder, Michael E, Riemann, Christopher D, Foster, Robert E, Sisk, Robert A
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-04-2019; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Bromfenac; Case Series; cataract; Cataract extraction; Cataracts; combined; Comparative analysis; diffractive; Difluprednate; Disease; Edema; epiretinal membrane; Eye surgery; intraocular lens; Intraocular lenses; Laboratories; Loteprednol; macular surgery; multifocal; Ophthalmology; Pathology; Patients; Pay-per-view television; phacoemulsification; phacovitrectomy; Pharmaceutical industry; Surgeons; Surgery; Surgical outcomes; vitrectomy; United States; United States > US; epiretinal membrane; combined; cataract; phacovitrectomy; multifocal intraocular lens; phacoemulsification
• ISSN: 1177-5467; 1177-5483; 1177-5483
• DOI: 10.2147/OPTH.S195928

The purpose of this study was to evaluate the functional and anatomical outcomes of combined phacovitrectomy with multifocal intraocular lens (mfIOL) implantation.
Retrospective, interventional, non-comparative case series of six eyes that received a combined phacoemulsification surgery with apodized, diffractive mfIOL implantation for cataract and pars plana vitrectomy (PPV) with membrane peeling for epiretinal membrane (ERM). Outcome measures included distance and near visual acuities (DVA and NVA), central macular thickness (CMT), intraocular pressure (IOP), and disruption of external limiting membrane (ELM) or inner-segment outer-segment (IS/OS) junction.
Mean logMAR glare DVA improved from 0.40 (Snellen 20/50) preoperatively to a mean uncorrected DVA of 0.038 (Snellen 20/22) (
=0.004) at 6 months after surgery. All eyes achieved NVA of J2 or better by 12 months postoperatively. Median CMT improved by 10 µm and mean IOP increased by 1 mmHg at 12 months postoperatively. Percentage of patients with ELM or IS/OS disruptions decreased from 66.7% to 33.3%. Two eyes demonstrated residual metamorphopsia on Amsler grid testing postoperatively. Postoperatively, four eyes required laser capsulotomy and one required LASEK for refractive correction.
Combined phacovitrectomy, membrane peeling, and mfIOL implantation improved VA in patients with idiopathic ERM. Multifocality was achieved, but final visual outcome was delayed due to posterior capsular opacification and macular healing.