Título

COMBINED PARS PLANA VITRECTOMY (PPV) AND PHACOEMULSIFICATION (PHACO) VERSUS PPV AND DEFERRED PHACO FOR PATIENTS WITH MACULAR HOLE OR EPIRETINAL MEMBRANE – PRELIMINARY RESULTS

Objetivo

To compare best-corrected visual acuity (BCVA) associated with combined PPV and phaco versus PPV and deferred phaco in patients with macular hole (MH) or epiretinal membrane (ERM) without significant cataract.

Método

Forty-nine patients (49 eyes) with MH (41) or ERM (8) with lens opacity lower than grade II cortical/nuclear according to the Lens Opacity Classification System (LOCS) III. Patients were randomly into two groups: Group I (PHACO + PPV) and Group II (PPV with deferred PHACO). We analyzed BCVA , MH size with Optical Coherence Tomography (OCT), macular sensitivity, specular microscopy and Tonometry at T0, T1, T3, T6, T9 and T12 months. In group II, phaco could be performed at any time postoperatively if the cataract severity was LOCS subcapsular ≥1 or nuclear ≥3 or cortical ≥3, or if the patient had, (1) any cataract that would prevent valid exams or (2) any decrease in visual acuity attributable to cataract.

Resultado

Partial results of 49 patients completed 12 months of follow-up, 29 Group I and 20 Group II.Mean BCVA (logMAR) was 0.93±0.05 and 0.91±0.06 at baseline and improved significantly to 0.59±0.06 and 0.57±0.09 at month 12 (p<0.0001) in groups I and II, respectively.MH closure rate was 72% and 78% (p = 0.35 qui square test) in groups I and II, respectively. Mean macular thickness in ERM was 452 ± 51 / 436 ± 95,36 μm decreased to 253±65,85 / 382,75 ± 191,01 μm in groups I and II, respectively. Mean endothelial cells density decreased, 2423.31 ± 75.30 to 2130.41 ± 92.61 and 2537.00 ± 70.35 to 2034.35 ± 119.53 in both groups (p<0,005). Mean macular sensitivity (dB) incresed Group I 18.52 ± 1.04 to 21.42 ± 0.89 and group II 17.68 ± 1.31 to 21.20 ± 1.37 (p <0,05). The mean intraocular pressure was 14.72 ± 0.58 and 15.80 ± 0.50 maintained 14.34 ± 0.54 and 13.85 ± 0.61, in both groups I and II, respectively (p= 0.745).

Conclusão

Combined PPV and phaco was associated with similar BCVA results when compared to PPV and deferred phaco in patients with MH or ERM.