Premium intraocular lens implantation in eyes with vitrectomy done

Abstract

Purpose: Phacoemulsification with premium intraocular lens (IOL) implantation has been increasingly popular in the recent years. However, it is not commonly implanted in eyes who had underwent previous vitrectomy surgery as the contrast sensitivity is thought to be reduced and surgeons are worried about poor visualization of the posterior segment after implantation. Since cataract and vitreoretinal diseases often coexist, premium IOLs should be a considerable option for implantation in carefully selected cases. This study aims at reporting the postoperative near and distance visual acuity and subjective quality of vision in eyes with premium IOLs implantation and vitrectomy done. Methods: Twenty eyes with posterior vitrectomy and premium IOL implantation from 2006 to 2018 were included. Fourteen eyes were included in Group 1 with patients who underwent a combined phacovitrectomy surgery in the same setting, and six eyes were included in Group 2 with patients who received premium IOL implantation after previous posterior vitrectomy. Results: Both the postoperative corrected distance and near visual acuity at 1 month, 3 month and 1 year are improved in both groups. The subjective quality of vision as graded by the National Eye Institute Refractive Error Quality of Life Instrument-42 questionnaire also showed high patient satisfaction in both groups. Conclusion: We conclude that the presence of a multifocal IOL does not impede visualization of the posterior segment during vitrectomy surgery and surgical complications were not raised. With careful patient selection and preoperative assessment, premium IOLs can be a considerable option in patients requiring posterior vitrectomy. Trial registration: Retrospectively registered with the HKSH Medical Group Research Committee (Ref No. RC-2019-31, Date of registration: December 13, 2019).