Surgical outcomes and complications of combined cataract phacoemulsification and silicone oil removal.

PURPOSE: To investigate the surgical outcomes of patients undergoing combined cataract extraction (CE) and silicone oil removal (SOR). METHODS: Charts of patients aged 18 and over who underwent combined CE and SOR between January 1, 2013, and December 31, 2023 were reviewed at four academic medical centers in Louisiana, United States. Surgical complications and outcomes were reported. Data was stratified by surgeon level of training and order in which operations were performed. RESULTS: Seventy-one eyes were included. The incidence of posterior capsule (PC) tear was 9% (6/71), and the incidence of dropped nucleus was 3% (2/71). The overall complication rate was lower in the eyes that underwent CE prior to SO removal [14% (7/51) vs. 32%(6/19), p = 0.005], but there was no significant difference in PC tear [8% (4/52) vs. 11% (2/19), p = 0.5] or dropped nucleus [2% (1/52) vs. 5% (1/19), p = 0.36]. When stratifying by surgeon training level, there was no statistically significant difference in PC tear [11% (5/46) vs. 4% (1/25), p = 0.41] or dropped nucleus [2% (1/46) vs. 4% (1/25), p = 0.54] between surgeries performed by residents versus fellows or attendings. The incidence of visually significant posterior capsule opacification was high, with 32 (45%) eyes and 10 (14%) eyes requiring early laser or intra-operative capsulotomy. CONCLUSIONS: Cataract extraction during combined CE and SOR has a high complication rate compared to routine surgery. Overall complication rate was lower in eyes that underwent CE prior to SOR. There was no significant difference between surgeries performed by residents compared to fellows and attendings.