Anmeldung zur Tagung
Registration
Grußwort
Invitation
Themen
Topics
Allgemeiner Ablauf
General overview
Wissenschaftliches Programm
Scientific program
Kurse
Courses
Symposien
Symposiums
Frühstück mit Spezialisten
Breakfast with specialists
Arzthelferinnen-Fortbildung
Rahmenprogramm
Social program
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
Combined pars plana vitrectomy and phacoemulsification via corneal or corneoscleral access?
¹Holtkamp A., 2Heiligenhaus A., 3Vij O., ¹Lösche C., ³Bornfeld N.
¹Augenklinik Ev. Krankenhaus, Wertgasse 30, Mülheim an der Ruhr; ²Augenklinik St. Franziskus-Krankenhaus, Hohenzollernring 72, Münster; ³Universitäts-Augenklinik Essen, Hufelandstr. 55, Essen
Objective: comparison of intra- and postoperative complications
in combined vitrectomy and phacoemulsification with implantation of an
IOL via corneal or corneoscleral incision
Methods: A prospective, randomized clinical study was conducted.
123 eyes were treated with a combined vitrectomy and phacoemulsification.
62 eyes(group A) got a PMMA lens (Pharmacia 811B) via corneoscleral access
and 61 eyes (group B) were treated with an Acryl-lens (Alcon Acrysof)
via corneal incision. Standardized examinations were performed two days
and three months postoperatve. Indication for vitrectomy presented macular
hole in 40, epiretinal gliosis in 39, retinal detachment in 20, affection
of the vitreous body in 21, AMD in 3 cases.
Results: Intraoperative we saw in 22 cases (group A: 10, B: 12)
a miosis, an instable anterior chamber in 7 (A: 2, B:. 5) cases, a bleeding
into the anterior chamber in 2 cases. 56 eyes (A: 33,B: 23, s=0,08) showed
folds in the posterior capsule after IOL implantation. On the second day
postoperative we found 63 eyes (8A: 25,B .38, s=0,02) with a corneal decompensation
and 51 (A: 32, B: 38, s=0,02) with an increased irritation of the anterior
chamber and 31 (A:12, B: 19, s= 0,11) with an increase of IOP. After three
months 48 eyes (A: 30,B: 18, s=0,04) had an opacification of the posterior
capsule, in 16 eyes (A: 7,B: 9) a posterior synechy occured and 13 (A:
5, B: 8) showed a change in corneal structure. An additional retinal operation
was necessary in 9 cases because of retinal detachment. Visual acuity
increased from 0,1(logMAR 1,0) to 0,22(logMAR 0,65)in average and 73 (A:
37, B: 36) patients attained a visual acuity of 2or more lines better,
a stable visual acuity was found in 26 eyes (A: 13, B: 13) and a decrease
in visual acuity occured in 18 (A: 8, B: 10) cases.
Conclusion: We could not find a difference in the occurrence of
complications using the corneal or corneoscleral access. Both operative
techniques are equally suitable for combined vitrectomy and phacoemulsification.