Femtophacovitrectomy. Case series and description of the technique

Objective: The aim of this study was to assess the safety and surgical results of combined pars plana vitrectomy and femtosecond laser-assisted cataract surgery (femtophacovitrectomy).

Material and methods: A prospective, non-comparative case series was conducted by selecting patients with cataract and vitreoretinal pathology who underwent femtophacovitrectomy by a single surgeon at the Hospital Central Militar between June 2013 and February 2014. An evaluation was made of the preoperative characteristics, surgical indications, results, and postoperative complications, with a minimum follow-up of 3 months.

Results: The study included 35 eyes of 35 patients, of whom 20 (57.1%) were male. The mean age was 60.76±4.2 years. Diagnoses included vitreous haemorrhage (19 cases), macular hole (6 cases), epiretinal membrane (7), and tractional detachment (5 cases). The mean best corrected visual acuity was 1.3 LogMAR before surgery, and 0.5 LogMAR at 3-months follow-up (P<.05). No patient had visual loss. The intra-operative complication was miosis in 14.28%. In the early postoperative period (<1 month), all had subconjunctival haemorrhage, with moderate corneal oedema in 20% of cases, and only 2.85% (one case) ocular hypertension associated with use of intraocular gas. There were no cases of endophthalmitis. The mean follow-up was 13.3 months (10-16 months).

Conclusions: The use of femtosecond laser in phacovitrectomy is a safe and effective alternative, with similar risk of complications in cases of macular pathology, tractional retinal detachment, and/or vitreous haemorrhage.