Objective: To evaluate the efficacy of cataract extraction and simultaneous intraocular lens (IOL) implantation during vitreous surgery for treatment of a series of patients with proliferative diabetic retinopathy (PDR) and cataract.
Methods: A consecutive series of PDR treated with vitrectomy and simultaneous IOL implantation during February 1997 and October 2001 was retrospectively analyzed.
Results: The series included 37 cases (12 males and 25 females) 44 eyes (OD 13; OS 17 and OU 7) with diabetic history for 1 - 30 years and eye symptoms for 40 days to 10 years. Surgical techniques included lensectomy or phacofragmentation via the pars plana. The anterior capsule was preserved and the epithelium was suctioned and scraped off. After vitreous surgery and endolaser, IOL was inserted via the corneoscleral incision on the anterior capsule, of which the center area 5 mm in diameter was cut. The patients was followed-up for 3 months to 4.5 years, mean (16 +/- 13) months. Visual acuity was light perception, hand motion, finger count, 0.02, and 0.1 - 0.2 in 5, 14, 11, 6, and 8 (18.2%) eyes, respectively before operation. Postoperatively, visual improvement was achieved in 41 eyes with 0.1 - 1.0 in 35 eyes (79.5%). Visual acuity remained unchanged in 2 eyes and decreased in one eye. Eyes with lower vision were associated with marked macular edema, hard exudates and severe ischemia. Six eyes had mild corneal edema 2 approximately 5 days after operation. Corneal ulcer or neovascular glaucoma occurred in 2 eyes 5 months after surgery.
Conclusion: Cataract extraction and simultaneous IOL implantation during vitreous surgery for PDR may improve the visual outcome in the majority of selected eyes without significant complications.