Outcomes and Safety of Femtosecond Laser-Assisted Phacovitrectomy Using 25-Gauge Pars Plana Vitrectomy.
- 1Department of Vitreoretinal Surgery, Dunyagoz Eye Hospital, Istanbul, Türkiye.
- 2Department of Ophthalmology, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Türkiye.
Abstract
Objectives
To evaluate the safety, visual outcomes, and complication profile of femtosecond laser-assisted cataract surgery (FLACS) combined with 25-gauge pars plana vitrectomy (PPV) in patients with concurrent cataract and vitreoretinal disease.Methods
This retrospective study included 57 eyes of 57 patients who underwent FLACS with a standardized 4.8-mm capsulotomy followed by 25-gauge PPV at a tertiary referral center in Istanbul, Turkey, between August 2020 and May 2025. Data collected included intraoperative events, postoperative best-corrected visual acuity (BCVA, Snellen converted to logMAR for analysis), intraocular pressure (IOP), and complication rates over a mean follow-up of 15.8±1.8 months.Results
Mean BCVA significantly improved from 0.68±0.34 logMAR preoperatively to 0.28±0.14 logMAR at 1 month, 0.19±0.11 logMAR at 3 months, and 0.15±0.14 logMAR at the final visit (all p<0.001). All eyes achieved meaningful visual recovery with stable and well-centered intraocular lenses and attached retinas. On postoperative day 1, post-hoc pairwise analysis revealed a significantly lower IOP in the air tamponade group compared with the SF6 and BSS groups (MD=-4.24, p<0.001); no significant IOP differences were found between groups at week 1, month 1, or month 3. Intraoperative complications included loss of cone suction (n=2, 3.5%) and incomplete capsulorhexis (n=2, 3.5%). Miosis occurred in 6 eyes (10.5%), and sclerotomy leakage requiring suturing in 7 eyes (12.3%).Conclusions
Combined FLACS and 25-gauge PPV is a safe and effective option for the management of coexisting cataract and vitreoretinal pathologies. The procedure provides favorable anatomical and visual outcomes with a low incidence of intraoperative and postoperative complications, supporting its use in appropriately selected patients. Prospective controlled studies are warranted to confirm these findings.
Related
- Twelve-month outcomes of subretinal tenecteplase-assisted vitrectomy for large submacular hemorrhage secondary to polypoidal choroidal vasculopathy: a retrospective consecutive case series
- Potential and Safety Assessment of a Hydrogel as a Vitreous Substitute Following Vitrectomy in an Ex Vivo Porcine Model.
- Comparison of clinical outcomes after 25-gauge vitrectomy with and without uncomplicated cataract surgery for idiopathic epiretinal membrane.
- Visual and Anatomical Outcomes of Vitrectomy with ERM and ILM Peeling in Idiopathic and Secondary ERM.
- Success of femtosecond laser-assisted deep anterior lamellar keratoplasty (Femto-DALK): a clinical case series of 42 eyes using an intraoperative optical coherence tomography (iOCT)-guided laser-generated pre-descemet tunnel.
BibTeX
@article{akkan2026outcomes,
title = {{Outcomes and Safety of Femtosecond Laser-Assisted Phacovitrectomy Using 25-Gauge Pars Plana Vitrectomy.}},
author = {Fevzi Akkan and Ersin Akbulut},
journal = {Beyoglu eye journal},
year = {2026},
month = oct,
doi = {10.14744/bej.2026.38802},
url = {https://europepmc.org/article/MED/42898541},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Outcomes and Safety of Femtosecond Laser-Assisted Phacovitrectomy Using 25-Gauge Pars Plana Vitrectomy.
AU - Fevzi Akkan
AU - Ersin Akbulut
PY - 2026
DA - 2026/10/01
JO - Beyoglu eye journal
DO - 10.14744/bej.2026.38802
UR - https://europepmc.org/article/MED/42898541
AB - Objectives To evaluate the safety, visual outcomes, and complication profile of femtosecond laser-assisted cataract surgery (FLACS) combined with 25-gauge pars plana vitrectomy (PPV) in patients with concurrent cataract and vitreoretinal disease.Methods This retrospective study included 57 eyes of 57 patients who underwent FLACS with a standardized 4.8-mm capsulotomy followed by 25-gauge PPV at a tertiary referral center in Istanbul, Turkey, between August 2020 and May 2025. Data collected included intraoperative events, postoperative best-corrected visual acuity (BCVA, Snellen converted to logMAR for analysis), intraocular pressure (IOP), and complication rates over a mean follow-up of 15.8±1.8 months.Results Mean BCVA significantly improved from 0.68±0.34 logMAR preoperatively to 0.28±0.14 logMAR at 1 month, 0.19±0.11 logMAR at 3 months, and 0.15±0.14 logMAR at the final visit (all p<0.001). All eyes achieved meaningful visual recovery with stable and well-centered intraocular lenses and attached retinas. On postoperative day 1, post-hoc pairwise analysis revealed a significantly lower IOP in the air tamponade group compared with the SF6 and BSS groups (MD=-4.24, p<0.001); no significant IOP differences were found between groups at week 1, month 1, or month 3. Intraoperative complications included loss of cone suction (n=2, 3.5%) and incomplete capsulorhexis (n=2, 3.5%). Miosis occurred in 6 eyes (10.5%), and sclerotomy leakage requiring suturing in 7 eyes (12.3%).Conclusions Combined FLACS and 25-gauge PPV is a safe and effective option for the management of coexisting cataract and vitreoretinal pathologies. The procedure provides favorable anatomical and visual outcomes with a low incidence of intraoperative and postoperative complications, supporting its use in appropriately selected patients. Prospective controlled studies are warranted to confirm these findings.
SN - 2459-1777
SN - 2587-0394
ER -