[Phacovitrectomy-Influence of the timing of intraocular lens implantation on the corneal endothelium].

BACKGROUND AND PURPOSE: In phacovitrectomy the cataract is usually operated on first including implantation of the intraocular lens (IOL) before beginning vitrectomy but the IOL can also be implanted following vitrectomy. This variation avoids optical impairments from corneal opacities and the lens rim, improves the visualization of the retina during surgery and might thereby reduce intraoperative complications, such as peripheral retinal tears or IOL subluxation. It might, however, increase stress on the corneal endothelium. The aim of this study was, therefore, to compare postoperative corneal endothelial cell loss for the standard procedure of phacovitrectomy and the surgical variation.

METHODS

In this retrospective study 41 eyes were each assigned to group I (standard phacovitrectomy) or group II (variation of phacovitrectomy). The primary endpoint was the absolute and relative corneal endothelial cell loss appearing 5 ± 1 weeks postoperatively with reference to the preoperative number of endothelial cells. Secondary endpoints included visual acuity, intraocular pressure, coefficient of variation of endothelial cell area (CV), proportion of hexagonal endothelial cell forms (6A), pachymetry, intraoperative and postoperative complications.

RESULTS

The absolute and relative endothelial cell loss in group I (-108 ± 146; -4.1 ± 5.7%) did not differ significantly from that in group II (-73 ± 122; -3.1 ± 5.3%, p = 0.299; p = 0.388). The secondary endpoints also showed no significant differences.

CONCLUSION

The presented variation of phacovitrectomy expands the surgical options and does not show a significantly different postoperative corneal endothelial cell loss compared to the standard procedure.