AUG 12, 2013
Cataract/Anterior Segment
The authors reviewed studies on refractive error in phakic and pseudophakic eyes that have undergone vitrectomy and phacovitrectomy for macular hole or epiretinal membrane.
They write that most phakic eyes with macular hole or epiretinal membrane that have vitrectomy will develop cataract. Therefore, the sequence of surgery has to be considered, i.e., performing combined phacovitrectomy; vitrectomy and subsequent cataract surgery; or cataract surgery and subsequent vitrectomy.
Most studies reviewed in this article found a postoperative myopic shift regardless of the sequence of the surgery. The article covers the various potential explanations for this shift, including the biometry for measuring the axial length, changes in the effective lens position, IOL type, the formula used to calculate the power of the IOL, use of gas tamponade, changes in keratometry, preoperative visual acuity, and type of macular pathology.
The authors conclude that further prospective studies regarding the sequence of surgery and the refractive outcome are necessary to optimize the refractive outcome.