| Objective: To evaluate the safety and efficacy of phase Ⅰ/Ⅱ cataract extraction with IOL implantation in the silicone oil tamponade pars plana vitrectomy,and to investigate the right time of cataract extraction in patients with vitreoretinal disease requiring silicone oil tamponade vitrectomy.Methods: We studied retrospectively the medical records of 50 patients(52 eyes)with phase Ⅰ/Ⅱ cataract extraction with IOL implantation in the silicone oil tamponade pars plana vitrectomy in our hospital between April 2017 to February2019.According to surgical methods,two groups were divided.Phase I cataract extraction with IOL implantation group had 26 patients(27 eyes),and 25patients(25 eyes)were in Phase Ⅱ cataract extraction with IOL implantation group.The best-corrected visual acuity,counts of corneal endothelial cells and postoperative complications after silicone oil tamponade surgery and silicone oil removal surgery were analyzed respectively.Results:BCVA(best-corrected visual acuity): 24 eyes(88.9%)of phase Ⅰ cataract extraction with IOL implantation group and 23 eyes(92.0%)of phase Ⅱ cataract extraction IOL implantation group had postoperative BCVA improved separately.The change of BCVA between two groups was not significantly statistically different(P=0.611).Counts of corneal endothelial cells: The number of corneal endothelial cells was significantly reduced in phase Ⅰ cataract extraction with IOL implantation group after combined with silicone oil tamponade vitrectomy,and in phase Ⅱ cataract extraction with IOL implantation group after combined with the silicon oil removal surgery seperately.The decrease number of corneal endothelial cell in phase Ⅰ and phase Ⅱ cataract extraction with IOL implantation group was461.96±363.31/mm2 and 376.44±371.63/mm2 respectively,and the difference between the two groups was not statistically significant(P=0.156).Complications after silicone oil tamponade surgery:15 eyes(55.6%)had complications in phase Ⅰ cataract extraction with IOL implantation group,while19 eyes(76.0%)had complications in phase Ⅱ cataract extraction with IOL implantation group,and there was no significantly statistical difference between the two groups(?2= 2.397,P = 0.122).Transient intraocular pressure rise was observed in 6 eyes(22.2%)in phase Ⅰ cataract extraction with IOL implantation group and 17 eyes(68.0%)in phase Ⅱ cataract extraction with IOL implantation group,the difference between the two groups was statistical significantly(P=0.001<O.05).Corneal edema,fibrinous exudation in the anterior chamber,formation of posterior synechi,and secondary glaucoma were observed in 6 eyes(22.2%),5 eyes(18.5%),2 eyes(7.4%),and 1 eye(3.7%)in phase Ⅰ cataract extraction with IOL implantation group and 2 eyes(8.0%),6eyes(24.0%),3 eyes(12.0%),and 0 eye(0%)in phase Ⅱ cataract extraction with IOL implantation group respectively.These mentioned complications above between the two groups had no statistic significant difference.Silicon oil efflux into the anterior chamber was observed in 7 eyes(25.9%)in phase Ⅰ cataract extraction with IOL implantation group and 0 eye(0%)in phase Ⅱ cataract extraction with IOL implantation group,the difference between the two groups was statistical significantly(P=0.020<O.05).Complications after silicone oil removal surgery:3 eyes(11.1%)had complications in phase Ⅰ cataract extraction with IOL implantation group,while8 eyes(32.0%)had complications in phase Ⅱ cataract extraction with IOL implantation group,and there was no statistic significant difference between the two groups(?2 =3.396,P=0.065).Transient intraocular pressure rise,corneal edema,fibrinous exudation in the anterior chamber,and formation of posterior synechi was observed in 0 eye(0%),2 eyes(7.4%),and 1 eye(3.7%) in phase Ⅰ cataract extraction with IOL implantation group and 2 eyes(8.0%),3eyes(12.0%),and 3 eyes(12.0%)in phase Ⅱ cataract extraction with IOL implantation group respectively.These mentioned complications above between the two groups had no statistic significant difference.Secondary cataract was observed in 8 eyes(29.6%)in phase Ⅰ cataract extraction with IOL implantation group,and 2 eyes(8.0%)in phase Ⅱ cataract extraction with IOL implantation group,and there was no statistic significant difference between the two groups(?2 =2.641,P=0.104).Conclusion:1.The best-corrected visual acuity after both phase Ⅰ and phase Ⅱ cataract extraction with IOL implantation silicone oil tamponade pars plana vitrectomy was significantly improved.The recovery of vision was not related to the differ of surgical procedure.2.Both phase Ⅰ and phase Ⅱ cataract extraction with IOL implantation silicone oil tamponade pars plana vitrectomy could cause corneal endothelial cell damage,and the corneal endothelial cell injury was mainly due to cataract extraction with IOL implantation.3.The happen of silicon oil efflux into the anterior chamber was more frequently in phase Ⅰ cataract extraction with IOL implantation combined with silicone oil tamponade pars plana vitrectomy,but less happen of postoperative transient high intraocular pressure.There was no difference in other postoperative complications between phase Ⅰ and phase Ⅱ cataract extraction with IOL implantation silicone oil tamponade pars plana vitrectomy.4.Both phase Ⅰ and phase Ⅱ cataract extraction with IOL implantation silicone oil tamponade pars plana vitrectomy were safe and effective methods for the treatment of complex vitreoretinal diseases with cataract. |
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