Clinical Aspects of Phacovitrectomy Complications

Abstract

In recent years, the incidence of vitreoretinal pathology has increased both in elderly and young patients. Such types of vitreoretinal pathology as macular holes, epiretinal membranes and vitreous opacities of various genesis require surgical intervention (vitrectomy) that may lead to cataract in the early postoperative period. Moreover, in elderly patients vitreoretinal diseases and cataract frequently accompany each other. From this, the necessity arises to perform phacovitrectomy. This procedure takes more time and is more technically complicated however, it is well tolerated by patients. There are several benefits of phacovitrectomy when complex ocular pathology, e.g., optimized visualization of the posterior segment, decreased amount of total surgical procedures, faster visual rehabilitation, and reduced risks and costs associated with a second surgery. However, some complications may still occur. The most common complications are posterior capsule opacification, increased postoperative inflammation, early postoperative IOP rising, and refractive errors. Numerous studies have described a mismatch between the expected postoperative refraction according to preoperative calculations and the actually achieved refraction. Most studies report about a negative refractive error. Various explanations have been suggested, including the biometry for measuring the axial length, changes in the effective lens position, IOL type, the formula used to calculate IOL power, the use of gas tamponade, and the type of macular pathology.