DIFFERENCES IN REFRACTIVE OUTCOMES BETWEEN PHACOEMULSIFICATION FOR CATARACT ALONE AND COMBINED PHACOEMULSIFICATION AND VITRECTOMY FOR EPIRETINAL MEMBRANE.

PURPOSE: To determine whether preoperative adjustments are required for intraocular lens calculations in combined phacovitrectomy surgery.

METHODS: A single-center, retrospective study of 50 eyes that underwent combined phacovitrectomy and a control group of 50 eyes after cataract surgery over a 3-year period by a single anterior segment surgeon and a single posterior segment surgeon. Main outcome measures were predicted refractive error (RE), as determined by SRK/T and Holladay 1 formulas, change compared with actual RE, surgically induced astigmatism, and the relationships between preoperative central foveal thickness or change in central foveal thickness and final RE.

RESULTS: The differences in predicted and final RE between groups were not statistically significant between groups when both SRK/T and Holladay 1 formulas were used (P > 0.05). Regardless of the formula used, final RE was neither significantly hyperopic nor myopic as compared to the target. There was no difference in surgically induced astigmatism between the two groups. Increased preoperative central foveal thickness was correlated with greater difference between predicted and actual RE. No relationship was noted between change in central foveal thickness and RE.

CONCLUSION: Combined phacovitrectomy for concurrent cataract epiretinal membrane by experienced cataract and vitreoretinal surgeons seems to deliver as predictable refractive results as cataract surgery alone.