Background: A cataract is frequently observed after pars plana vitrectomy with silicone oil endotamponade.
Patients and methods: Forty-three consecutive patients underwent cataract surgery combined with transpupillary removal of silicone oil. After phacoemulsification of the lens material through a sclerocorneal tunnel incision, a planned posterior capsulorhexis with a diameter of 3-4 mm was performed. By injecting saline through the capsulorhexis into the vitreous cavity, the silicone oil was rinsed out. Widening of the sclerocorneal tunnel facilitated the drainage of the silicone oil through the pupil and tunnel. After ophthalmoscopic evaluation of the fundus, a plano-convex PMMA posterior chamber lens was implanted into the capsular bag or ciliary sulcus, and the corneoscleral tunnel was closed by a 10-0 nylon suture.
Results: Depending on the underlying retinal disease the visual acuity improved in some eyes. Silicone oil bubbles left behind in the vitreous cavity were smaller than 0.5 mm in diameter. Persisting corneal decompensation or a clinically detectable cystoid macular edema related to cataract surgery did not occur. Due to the posterior capsulorhexis, secondary cataract did not develop postoperatively. Small postoperative vitreous hemorrhages resolved during the first three post-operative days. Retinal detachment recurred in 11 eyes (11/42 or 26.2%). In one eye, dislocation of the pseudophacos occurred which had to be corrected surgically. Since the pars plana region remained untouched, direct retinal lesions in the periphery of the fundus or marked vitreous hemorrhages were not encountered.
Conclusions: Silicone oil removal can be combined with cataract surgery with transpupillary drainage of the silicone oil.