Abstract:·AIM:To find the best surgical way to treat patients who had proliferative retinopathy combined with cataract by different surgical methods and observe the long-term effect during the process of vitrectomy.·METHODS:Fifty PDR cases 50 eyes coexisted with cataracts who underwent two different combined surgeries from Jun.2006 to Aug.2009 were reviewed.These cases were randomly divided into two groups.Group A included 25 cases 25 eyes who were treated with phacoemulsification combined with vitrectomy,IOLs were implanted into the capsular bag via the clear corneal incision at the end of the surgeries.While group B included another 25 cases 25 eyes who were treated with the technique of lensectomy via the pars plana combined with vitrectomy,the anterior capsule was preserved and the cortex and nucleus were aspirated,IOL was implanted via the cornea-scleral incision on the anterior capsule at the end of the surgeries.Standard pars plana vitrectomy was performed,many relative key technologies such as membrane dissections and membranectomy were adopted.Implantations of silicon oil were adapted to some eyes at the end of the surgeries.The clinical data,such as vision,anterior chamber reaction,iris neovascularization,IOP,capsular opacification and the location of IOL were observed postoperatively.·RESULTS:All posterior or anterior capsular membranes were preserved without damage.Implantations of silicon oil were adapted to 15 cases 15 eyes in both groups respectively.IOL implantations were performed in 15 eyes in group A,while 18 eyes in group B.The average follow-up time was from 3 months to 22 months.There was no significant difference in postoperative best-corrected vision between the 2 groups(P>0.05),while there were more capsular opacification and more dislocation of IOL in group B than in group A(P<0.05).·CONCLUSION:Phacoemulsification and intracapsular IOL implantation combined with vitrectomy in the treatment of proliferative retinopathy and cataract is safer and more effective than pars plana lensectomy combined with vitrectomy.The design of IOL is in accordance with the physiological and anatomical structure of the eyeball which can lower the incidence of capsular opacification,dislocation of IOL and postoperative inflammation.·
