Comparison of postoperative refractive outcome in eyes undergoing combined phacovitrectomy vs cataract surgery following vitrectomy

  • Paris G. TranosEmail author
  • Bruce Allan
  • Miltiadis Balidis
  • Athanasios Vakalis
  • Solon Asteriades
  • George Anogeianakis
  • Magda Triantafilla
  • Nikolaos Kozeis
  • Panagiotis Stavrakas
Retinal Disorders



To investigate the accuracy of preoperative biometry in eyes undergoing combined phacovitrectomy and to compare it with eyes having cataract surgery at a later point in time following vitrectomy.


Patients with epiretinal membrane or macular hole who underwent combined phacovitrectomy (group 1) or phacoemulsification following pars plana vitrectomy (PPV) (group 2) were included in this retrospective, comparative, interventional case series. The primary outcome measures were the intraocular lens power prediction error (PE) and the percentage of eyes with PE > ± 0.5D in the two groups. Secondary outcome measures included the correlation between epidemiological, clinical, or surgical factors and dioptric shift. In addition, the influence of optical coherence tomography characteristics to the PE was investigated.


Group 1 and 2 consisted of 55 and 54 eyes, respectively, for a total of 109 eyes included in the study. The mean absolute PE was 0.59 D (range + 1.4 to − 2.5D) in group 1 and 0.35 (range + 1.0 to − 1.45D) in group 2 (p = 0.01). PE greater than 0.5D was observed in 47% of eyes in group 1 as opposed to 16.6% of eyes in group 2 (p = 0.027). The PE was associated with shallower anterior chamber depth (ACD), increased central macular thickness (> 300 μ), and worse baseline best-corrected visual acuity. Photoreceptor ellipsoid zone or external limiting membrane disruption was not associated with significantly greater postoperative refractive deviations.


Combined phacovitrectomy may result in greater postoperative refractive prediction error compared to phacoemulsification alone following vitrectomy. Patients with worse vision, greater central macular thickness, and shallow anterior chambers require more caution since they are prone to inaccurate preoperative biometry.


Phacovitrectomy Vitrectomy Refractive error Prediction error Epiretinal membrane Macular hole 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the Ophthalmica Eye Institute and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • Paris G. Tranos
    • 1
    Email author
  • Bruce Allan
    • 2
  • Miltiadis Balidis
    • 1
  • Athanasios Vakalis
    • 1
  • Solon Asteriades
    • 1
  • George Anogeianakis
    • 3
  • Magda Triantafilla
    • 1
    • 4
  • Nikolaos Kozeis
    • 1
  • Panagiotis Stavrakas
    • 5
  1. 1.Ophthalmica Eye InstituteThessalonikiGreece
  2. 2.Moorfields Eye HospitalLondonUK
  3. 3.Leicester Royal InfirmaryLeicesterUK
  4. 4.Association for Biomedical TechnologyThessalonikiGreece
  5. 5.Department of OphthalmologyUniversity of Patras Medical SchoolPatrasGreece

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