Objective: This study aimed to compare the long-term functional and anatomical outcomes of combined phacovitrectomy and sequential vitrectomy and cataract surgery for macular hole (MH) and cataract.

Methods: This retrospective comparative study analyzed the medical records of 58 patients who underwent phaco vitrectomy (n=24) or sequential surgery (n=34) for MH and cataract between March 2014 and March 2016. Patients were divided into the combined surgery group, which underwent combined surgery for MH and cataract extraction, and the sequential surgery group, which underwent vitrectomy first, followed by cataract extraction. The primary outcome measures were the best-corrected visual acuity (BCVA) before surgery and at 3, 6, 12, and 24 months after surgery and successful hole closure.

Results: A total of 58 patients were included in this study. The change in BCVA at 3 months after surgery was significantly better in the combined surgery group than in the sequential surgery group. However, no significant difference was found between the groups at 6, 12, and 24 months after surgery. Cataract surgery was performed at 4.9±1.2 months after the first surgery (vitrectomy) in the sequential surgery group. In the success group, the rates of hole closure were 95.8% (23/24) and 97% (33/34) in the combined and sequential surgery groups, respectively.

Conclusion: Combined phaco vitrectomy and sequential vitrectomy and cataract surgery are safe and effective methods for treatment of MH and cataract. Although both methods demonstrate similar anatomical and functional success, combined surgery appears superior over sequential surgery because of the early visual improvement, decreased patient morbidity, and lower cost.