To evaluate the postoperative refractive prediction error (PE) and determine the factors that affect the refractive outcomes of combined pars plana vitrectomy (PPV) or silicone oil removal (SOR) with cataract surgery.

The study is a retrospective, case-series study. Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled. Eligible individuals were separated into four groups according to their preoperative diagnoses: silicone oil-filled eyes after PPV (group 1), epiretinal membrane (group 2), macular hole (group 3), and primary retinal detachment (RD; group 4). The variables affecting postoperative refractive outcomes were analyzed, including age, gender, preoperative best-corrected visual acuity (BCVA), axial length (AL), keratometry average, anterior chamber depth (ACD), intraocular tamponade, and vitreoretinal pathology. The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within ±0.50 diopter (D) and ±1.00 D.

For all patients, the mean PE was -0.04±1.17 D, and 50.17% of patients (eyes) had a PE within ±0.50 D. There was a significant difference in refractive outcomes among the four groups (P=0.028), with RD (group 4) showing the least favorable refractive outcome. In multivariate regression analysis, only AL, vitreoretinal pathology, and ACD were strongly associated with PE (all P<0.01). Univariate analysis revealed that longer eyes (AL>26 mm) and a deeper ACD were correlated with hyperopic PE, and shorter eyes (AL<26 mm) and a shallower ACD were correlated with myopic PE.

RD patients have the least favorable refractive outcome. AL, vitreoretinal pathology, and ACD are strongly associated with PE in the combined surgery. These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

To investigate the effects of clearing meibomian gland ducts prior to cataract surgery on the gland dysfunction and dry eye induced by surgery.

A prospective, randomized controlled trial was conducted on 110 patients (110 eyes) undergoing elective cataract surgery for senile cataract in our department from June 1, to December 31, 2021. The participants were randomly allocated into treatment (n=56) and control (n=54) groups. The patients from the treatment group were given eyelid compresses and cleaning to remove an obstructed meibum in 1 week prior to cataract surgery, while those from the control group received no such treatment. Ocular surface disease index (OSDI), indicators related to meibomian gland function, including tear film lipid layer thickness (LLT), meibomian glands yielding liquid secretion (MGYLS), meibomian glands yielding secretion score (MGYSS), and tear film break-up time (TBUT) before, and 1 and 3 months after surgery were employed to evaluate the efficacy of clearing meibomian gland ducts.

The control group exhibited significantly decreased MGYLS (P<0.05), increased MGYSS (P<0.01), thinner LLT (P<0.01), shorter TBUT, worsened dry eye symptoms, and elevated OSDI score (P<0.05) in 1 month after surgery. Conversely, the treatment group showed significantly improved MGYLS (P<0.01), decreased MGYSS (P<0.01), thicker LLT, extended TBUT, and improved subjective outcomes reported on OSDI.

Our preoperative meibomian gland treatment prior to cataract surgery may be a safe and effective intervention for relieving dry eye and meibomian gland dysfunction induced by surgery.