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  • Title: Sutureless combined 25-gauge vitrectomy, phacoemulsification, and posterior chamber intraocular lens implantation for management of uveitic cataract associated with posterior segment disease.
    Author: Soheilian M, Mirdehghan SA, Peyman GA.
    Journal: Retina; 2008; 28(7):941-6. PubMed ID: 18698295.
    Abstract:
    PURPOSE: To report visual outcomes and complication rates associated with one-stage surgery for the management of uveitic cataract associated with posterior segment disease. METHODS: In this interventional case series, 19 eyes (19 patients) with posterior segment involvement due to chronic uveitis underwent sutureless scleral tunnel incision phacoemulsification combined with total vitrectomy using 25-gauge instruments and posterior chamber intraocular lens (PC-IOL) implantation. Membrane peeling and endolaser photocoagulation were performed when indicated. Outcome measures were visual acuity, inflammatory activity, macular edema, and complications of surgery. RESULTS: After a minimum 12-month follow-up, visual acuity was >or=20/100 in 12 eyes (63.2%); 6 eyes (31.6%) had visual acuity of >or=20/40. A decrease in postoperative inflammatory activity of 1 grade was observed in 8 eyes (42.1%). Sixteen eyes had cystoid macular edema before surgery; and 12 eyes had cystoid macular edema after surgery. Early postoperative complications included the following: transient corneal edema, 10 eyes (50.3%); fibrin reaction, 3 eyes (15.8%), and posterior synechiae, 9 eyes (47.3%). Glaucoma was the most common late postoperative complication (3 eyes [18.8%]). Nine eyes (47.4%) needed YAG laser capsulotomy during the first year. CONCLUSION: Sutureless combined 25-gauge total vitrectomy, phacoemulsification, and PC-IOL implantation may be well tolerated with an acceptable complication rate for selected uveitic eyes with significant cataract and coexisting posterior segment disease for restoring useful vision.
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