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¹MD, Harvey and Bernice Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
²BS, College of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
³MD, Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, Texas, USA
⁴BS, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
⁵MD, PhD, Ophthalmology Department, Ain Shams University, Cairo, Egypt DOI : 10.37845/ret.vit.2024.33.26 Cataract development and progression after pars plana vitrectomy (PPV) is nearly universal among older adults. Therefore, the surgical approach to PPV among these patients may include combined cataract surgery and PPV (phacovitrectomy) or lens-sparing PPV followed by sequential cataract surgery once the cataract is visually significant. Both approaches have advantages and disadvantages that should be considered. Combined phacovitrectomy is less costly and reduces the risk of trauma to the crystalline lens or posterior capsule during PPV but can result in poor fundal view during vitrectomy, prolonged visual rehabilitation, and IOL dislocation from intraocular tamponade. Staged/sequential surgery avoids the limitations of a combined approach, but is associated with higher cost and more complex cataract extraction due to anterior chamber instability and possible PPV-related zonular or posterior capsule injury. In this review, we discuss both surgical approaches and share important preoperative and intraoperative considerations derived from our experience and the existing ophthalmic literature. Keywords : Pars plana vitrectomy, phacoemulsification, cataract, combined sequential staged retroillumination