The effect of mydriatics on posterior synechia after combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation.

Abstract

To compare short-acting mydriatics versus long-acting mydriatics and to assess their effect on postoperative frequency and severity of posterior synechia after combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation. We retrospectively reviewed the records of 69 eyes of 69 patients who received a combined operation by the same surgeon for rhegmatogenous retinal detachment and cataracts. The mean follow-up period in both groups was 43 weeks. The frequency and severity of posterior synechia were analyzed at baseline and over a 6-month follow-up period. Of the 69 eyes, 29.7% (11 of 37) in the long-acting mydriatic group versus 9.4% (3 of 32) in the short-acting mydriatic group had developed posterior synechia. The difference was statistically significant (P = 0.036). Additionally, when the severity of posterior synechia was measured in hour units, there was a statistically significant difference in severity between the 2 groups (long-acting mydriatic group, 0.76 +/- 1.52 hours; short-acting mydriatic group, 0.13 +/- 0.42 hours; P = 0.020). The frequency and severity of posterior synechia after a combined operation may be reduced by the use of a short-acting mydriatic.