PHACOEMULSIFICATION COMBINED WITH SILICONE OIL REMOVAL THROUGH THE POSTERIOR CAPSULORHEXIS TEAR ERIC FRAU, MD,* MARIE LAUTIER-FRAU, MD,‡ MARC LABETOULLE, MD,* SARA HUTCHINSON, MD,† HERVE OFFRET, PHD* Purpose: To evaluate phacoemulsification combined with silicone oil removal through the posterior capsulorhexis tear. Method: The records of 20 patients with cataract after silicone oil repair of retinal detachment with giant retinal tear or complicated by proliferative vitreoretinopathy were reviewed. All eyes underwent phacoemulsification, posterior capsulorhexis, aspiration of silicone oil with an irrigation–aspiration hand piece, and intraocular lens implantation into the capsular bag. Lens calculation was based on the fellow eye. The mean follow-up period after cataract surgery was 15.4 months. Results: There were three recurrences of retinal detachment (15%). Transient corneal edema was noted in two eyes. Unpredictable refraction was the main problem, but the myopic refractive error was 4.5 diopters in all cases. Conclusion: Cataract extraction combined with silicone oil removal is an effective technique. RETINA 22:158 –162, 2002 S ilicone oil is useful in the treatment of some cases of retinal detachment with severe proliferative vit- reoretinopathy. 1–3 There are several potential compli- cations caused by silicone oil such as keratopathy, glaucoma, and cataract formation. 3–5 When silicone oil remains in contact with the lens, a feathery poste- rior subcapsular cataract is produced. With prolonged silicone–lens contact, a permanent cataract will form in all cases. 6 –10 To reduce the incidence of postoper- ative complications in silicone-filled eyes, many re- searchers recommend that silicone oil should be re- moved from the eye as soon as there is retinal stabilization. 3,4,9,11,12 The aim of this study was to assess whether phacoemulsification and silicone oil removal through a planned posterior capsulorhexis tear can be combined as an effective technique. Patients and Methods This retrospective study included 20 patients (12 females and 8 males; age range, 9 – 82 years [mean age, 57 years]) who were treated at the Department of Ophthalmology, Hôpital Bicêtre, Le Kremlin Bicêtre, France, between December 1996 and June 2000. The same surgeon (E.F.) operated on all patients. Pars plana vitrectomy, membrane peeling, band encircling, intraoperative use of perfluorocarbon liquids, en- dophotocoagulation, and silicone oil (1,300 centist- okes) tamponade were performed 6 months before removal of silicone oil. The reason for pars plana From the *Department of Ophthalmology, Hôpital de Bicêtre, Le Kremlin Bicêtre; the †University of Paris XI; and the ‡Depart- ment of Ophthalmology, Pitié-Salpétrière Hospital, France. The authors have no proprietary or financial interest in any material relating to this research. Reprint requests: Eric Frau, MD, Department of Ophthalmology, Hôpital de Bicêtre, 78 avenue du Général Leclerc, 94270, Le Kremlin Bicêtre, France. 158