Combined pars plana vitrectomy and phacoemulsification with intraocular lens implantation in severe proliferative diabetic retinopathy.

BACKGROUND AND OBJECTIVE: To evaluate the results of combined vitrectomies and intraocular lens implantations in cases of proliferative diabetic retinopathy. PATIENTS AND METHODS: Data from procedures on 117 eyes (91 patients) undergoing combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation for the complications of proliferative diabetic retinopathy were analyzed retrospectively. Follow-up ranged from 8 to 64 months (median = 25 months). RESULTS: Retinal tears were the most frequent intraoperative problems (19%). Limited postoperative fibrin formation occurred in 22% of eyes. Within 6 months, 7% developed glaucoma and 2% showed new anterior segment rubeosis. Overall, 10% underwent secondary surgical procedures as follows: lavage for hemorrhage (n = 3), silicone oil exchange after 7 days for focal rebleeding (n = 1), silicone oil surgery for retinal detachment after gas resorption (n = 1), and lavage for late vitreous hemorrhage (7 to 13 months) (n = 4). Half of the secondary procedures were necessitated within 3 months of the original surgery. CONCLUSIONS: Combined surgery in proliferative diabetic retinopathy is safe and effective. It should be considered when lens opacities are either present or likely to develop soon.