Usporedba vidnog ishoda i komplikacija nakon operacije katarakte i vađenja silikonskog ulja aktivnom i pasivnom metodom Comparison of visual outcomes and complication after cataract extraction and silicone oil removal with active and passive methods

摘要

Combined operation of cataract extraction and silicone oil removal is very complex. There are two ways of removing silicone oil passive hydrodynamic expression through the planned posterior capsulorhexis and active suction through scleral incision.udThe objectives of this study were:1 determine efficiency cataract surgery and silicone oil removal through a planned posterior capsulorhexis in the rehabilitation of visual acuity ud2. Identify risk factors and asses their role in the occurence of postoperative complications in cataract surgery and silicone oil removal through a planned posterior capsulorhexis or pars plana scleral incisions.udThe study included patients hospitalized in the Department of Ophthalmology University Hospital Center ''Sestre milosrdnice'' in Zagreb bacause of cataract surgery and silicone oil removal after pars plana vitrectomy. In a prospective randomized study included 130 patients. In group 1 silicone oil is removal by passive hydrodynamic expression through the planned posterior capsulorhexis, included 64 patients. In group 2 silicone oil is removal actively suction through scleral incisions, included 66 patients. The mean age at first group was 61 years (28-82) while in the group 2 was 63 years (32-80). After surgery all patients are controlled 1,7,14,35 and 56 days after surgery. Survey results showed that there was no statisticcaly significant difference in preoperative visual acuity between randomized groups. During the first postoperative days was recorded statisticaly significant difference in improvement of visual acuity between groups, and 56 postoperative days in favor of the first randomized group.udThe study found no statistically significant difference in the level opacity of the lens, as well as preoperative values of intraocular pressure between the group.udThere was a statistically signifcant difference in preoperative and postoperative intraocular pressure in all the days of monitoring in both groups.udAnalyzing opacification of the posterior capsule was also found statisticcaly significant differences between randomized groups, in favor of the first randomized group. udResults of analysis vitreous hemorrhage showed a statisticcaly significant diference between randomized groups first nad 56 days after surgery in favor of the first group.udRetinal detachment in randomized group showed no statisticcaly significant difference.udAnalyzing the postoperative keratopathy we found a statistically significant difference in favor of the first group, the first postoperative day. Because the silicone oil is extracted in the second group with active method results can not be attributed to the toxic effects of silicone udoil but with the probable operative trauma caused by the phacoemulsification cataract surgery.udThe data obtained in this prospective randomized study confirm the hypothesis that cataract surgery and silicone oil removal with passive hydrodynamic expression through the planned posterior capsulorhexis lead to quicker recovery of visual acuity and less postoperative complications.