Pars Plana Vitrectomy Combined With Either Secondary Scleral Fixated or Anterior Chamber Intraocular Lens Implantation




We read the article published by Melamud and associates, entitled “Pars Plana Vitrectomy Combined With Either Secondary Scleral Fixated or Anterior Chamber Intraocular Lens Implantation.” The article addressed an interesting topic, but there are some drawbacks in that study.


First we should note that visual outcome after intraocular lens implantation (IOL) and pars plana vitrectomy is related to several factors, including the pars plana vitrectomy procedure, which was done by several surgeons; the type of intraoperative tamponade, such as gas or silicone oil; and the incision size that was used during vitrectomy for IOL removal (some IOLs were not foldable). Because of underlying ocular problems, it seems that improvement in visual acuity compared with the preoperative state is a better determinant. Second, the information given by the authors is insufficient; they did not tell anything about possible hypotonia or wound leakage and cystoid macular edema. Third is the length of follow-up; the authors mentioned at least 6 months of follow-up for patients, but some of the complications, such as corneal edema, IOL dislocation, and hyphema, could not be easily limited to 6 months. Fourth, we could not simply associate epiretinal membrane formation to the type of IOL implantation, especially in patients with complicated cataract surgery undergoing pars plana vitrectomy; each of these surgeries and related factors, such as complications during vitrectomy not mentioned by the authors or the type of tamponade, could affect the chance of epiretinal membrane formation. Finally, aphakic artisan IOLs are notable options in this setting, as our practice shows.

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Jan 5, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Pars Plana Vitrectomy Combined With Either Secondary Scleral Fixated or Anterior Chamber Intraocular Lens Implantation
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