Choice of Surgical Technique in the Management of Cataract Combined with Vitreous Surgery

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Abstract
Purpose.: To compare different methods of lens removal during vitreous surgery. Methods.: We reviewed the data of 37 consecutive eye operations with combined surgery of the lens and vitreous in the Mülheim Eye Hospital between March ‘93 and September ‘94. Results.: In 14 eyes a pars plana lensectomy was done, in 7 an ECCE (extra capsular cataract extraction), and in 16 phacoemulsification was combined with a regular threeport pars plana vitrectomy. Conclusions.: The choice of procedure was mainly influenced by the hardness of the lens and whether an IOL implant was considered. If no IOL is planned and the lens is soft enough, the best way to remove it is by pars plana lensectomy. If the nucleus seems too hard, phacoemulsification should be performed, because of the risk of releasing the nucleus into the posterior segment. If an IOL is planned, the best method of lens removal is phacoemulsification via a scleral tunnel. In both cases if the nucleus is very hard ECCE should be performed because of the risk of corneal edema.