Abstract

SO.09.04

Postoperative recovery following 23G vitrectomy is not delayed by a simultaneous clear cornea phacoemulsification

Wolfgang Schrader1, Stefanie Schunder2
1Maximilians-Augenklinik, Nürnberg, 2Universitäts-Augenklinik Würzburg

Objective
23 G pars-plana vitrectomy (PPV) has become the new standard in central Europe. Nowadays, PPV is often combined with cataract surgery. We have recently shown, that the time for surgery is equal  for 20G and 23G [1]. We now analyzed the differences in the postoperative course between 20G and 23G PPV and the influence of a simultaneous cataract surgery.
Methods
In 113 eyes we performed PPV without cataract surgery (90 in 23G and 23 in 20G) and in 280 eyes PPV with simultaneous cataract surgery (66 in 23G, 20 in 20G with a clear cornea approach (CC-phaco) and 237 in 20G with sclerocorneal 6mm-tunnel (SC-phaco)). The postoperative use of steroids was compared between all subgroups. Indication for surgery was similar in all subgroups.
Results
The dose of steroids is slightly higher in PPV with simultaneous cataract surgery Is one assumes that a subconjunctival injection of steroids is equal to 24 drop equivalents (DE), a 23G PPV alone needed 8.1 DE, a 20G PPV alone 9.4 DE, a combined 23G PPV with CC-phaco 9.4 DE, a 20G PPV with CC-phaco 14.4 DE, and a 20G PPV with a SC-phaco 18,1  DE. Rarely, postoperative hypotension was observed following 23G PPV, with no need of a secondary suture, but a postoperative fibrinous reaction was observed less frequently than following 20G PPV. Postoperative recovery was faster in eyes with 23G surgery than after 20G surgery, with no delay by a simultaneous cataract surgery. 
Conclusions
A 23G-PPV is no obstacle for a simujltaneous cataract surgery. Psotoperative recovery is faster and the new technique has less side effects than the conventional technique. 

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