Combined Pars Plana Vitrectomy, Phacoemulsification and Intraocular Lens Implantation: A review on the Advantages and Limitations of Phacovitrectomy

When vitreoretinal and anterior segment surgeons collaborate to perform concomitant cataract-vitreoretinal surgery (also known as phacovitrectomy) in the appropriate clinical setting, combined surgery can expedite visual recovery, improve the view and surgical access to the retina in cases with significant cataract, avoid multiple rounds of anaesthesia and reduce the financial burden on the patient. While combined surgery overcomes several limitations of sequential surgery, it is important to understand that phacovitrectomy may be associated with increased postoperative inflammation and less predictable refractive outcomes. We typically recommend combined phacovitrectomy in patients with significant cataract and vitreoretinal pathology, especially if the cataract impairs the view to the retina or if the patient is too ill to undergo several rounds of anaesthesia. In patients with high refractive expectations who have an early cataract or mild retinal pathology, combined surgery is not likely to be a viable or reasonable management option.