Our Summary

This study looks at the safety of a particular type of cataract surgery that uses a femtosecond laser, combined with a procedure called vitrectomy. This was a retrospective study, meaning they looked back at patients who had already had the procedures. These patients were treated between August 2016 and April 2018 at a medical school in Tokyo, Japan, and were followed for at least 3 months after their surgeries.

The procedures involved using a femtosecond laser to perform capsulotomies (creating an opening in the capsule of the eye) and fragment the lens of the eye. After this, a 25 or 27-gauge vitrectomy was performed, which is a surgical procedure that removes some or all of the vitreous humor from the eye.

The study found that out of 34 patients, 33 had successful coverage of their intraocular lens by the edge of the anterior capsule. In one case there was a rupture in the posterior capsule due to an error during emulsification - the process of breaking down the lens - and aspiration of a fragment of the lens. However, the intraocular lens was still able to be secured within the eye.

After surgery, some patients experienced complications including inflammation and swelling inside the eye, the formation of membranes on the retina, and clouding of the capsule that holds the lens. However, these complications were not caused by the femtosecond laser.

The study concluded that in most cases, this combined surgery provided good lens placement within the capsule without affecting the pressure inside or outside of the eye, and good vision during and after the operation. However, the benefits and drawbacks of using the femtosecond laser should be carefully considered.

FAQs

  1. What is femtosecond laser-assisted cataract surgery (FLACS) combined with 25- or 27-gauge vitrectomy?
  2. What were the results of the retrospective study on FLACS combined with 25- or 27-gauge vitrectomy?
  3. Were there any complications associated with femtosecond laser-assisted cataract surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vitrectomy is to follow all postoperative instructions carefully, including any restrictions on physical activity or eye care. It is important to attend all follow-up appointments to monitor healing and address any concerns promptly. Additionally, maintaining good overall health and following a healthy lifestyle can help support recovery and optimize outcomes after vitrectomy surgery.

Suitable For

Patients who are typically recommended vitrectomy include those with conditions such as:

  1. Retinal detachment
  2. Macular hole
  3. Epiretinal membrane
  4. Diabetic retinopathy
  5. Vitreous hemorrhage
  6. Vitreomacular traction syndrome

These conditions may require vitrectomy to remove blood, scar tissue, or other debris from the vitreous gel in the eye in order to restore or improve vision.

Timeline

Before vitrectomy, a patient may experience symptoms such as blurry vision, floaters, flashes of light, or a curtain-like shadow over their field of vision. They may undergo various tests and evaluations to diagnose the issue and determine if vitrectomy is necessary.

After vitrectomy, the patient may experience some discomfort, redness, and swelling in the eye for a few days. They will need to follow post-operative care instructions, which may include using eye drops, avoiding strenuous activities, and attending follow-up appointments. Over time, their vision should improve as the eye heals, although it may take several weeks to months for full recovery. Some patients may also experience complications such as endophthalmitis, macular edema, epiretinal membranes, or postoperative capsular opacification, which may require additional treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with femtosecond laser-assisted cataract surgery (FLACS) combined with vitrectomy?
  2. How long is the recovery period after undergoing FLACS combined with vitrectomy?
  3. Will I need any additional follow-up appointments after the procedure?
  4. Are there any specific post-operative care instructions I should follow?
  5. How will my vision be impacted after the surgery, and what can I expect in terms of visual outcomes?
  6. Are there any specific factors that may make me a better or worse candidate for FLACS combined with vitrectomy?
  7. How experienced are you in performing this combination procedure, and what is your success rate with it?
  8. Will I need any additional treatments or interventions in the future following FLACS combined with vitrectomy?
  9. Are there any lifestyle changes I should consider after undergoing this procedure?
  10. Are there any alternative treatment options to consider for my specific eye condition?

Reference

Authors: Kubota M, Watanabe A, Watanabe T, Kono H, Hayashi T, Nakano T. Journal: Int Ophthalmol. 2020 Apr;40(4):943-949. doi: 10.1007/s10792-019-01266-7. Epub 2020 Jan 8. PMID: 31916059