Purchase this article with an account.
Yasha Modi, Aliza Epstein, William Smiddy, William Feuer, Harry Flynn; Retained Lens Fragments After Cataract Surgery: Outcomes of Same-Day Versus Delayed Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5768.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare visual acuity (VA) outcomes and adverse events in patients with retained lens fragments (RLFs) undergoing same-day versus delayed pars plana vitrectomy (within one week and greater than one week).
Retrospective, consecutive case series over a 22-year period (1990-2011) at a university referral center.
The study included 569 eyes of 568 patients, with a median age of 74 years and a median follow up of 8 months (1 week - 100 months). Excluded from the analysis were 21 patients who did not have follow-up VA recorded. 117 eyes (21%) received same-day vitrectomy, 131 eyes (23%) received PPV within one week and 321 eyes (56%) received delayed PPV. Median time to vitrectomy in the same-week group was 5 days compared to 22 days in the delayed group. At 3 months, 6 months, and at last examination after vitrectomy, there were no statistically significant differences in VA outcomes between groups (P≥0.095). At the last examination, 61%, 63%, and 59% of patients receiving same-day, within one week, and greater than one week PPV respectively achieved VA ≥ 20/40 (P=0.35) and 16%, 15%, and 21% had VA ≤ 20/200 (P=0.29). There were no differences between groups when assessing cystoid macular edema (P=0.96), retinal detachment (P=0.096), intraocular pressure > 30mmHg (P=0.88), vitreous hemorrhage (P=0.57), or suprachoroidal hemorrhage (P=0.26). The most common cause of reduced VA (≤ 20/40) was cystoid macular edema (20%), followed by retinal detachment (13%), preexisting ocular disease (11%), macular degeneration (10%), and corneal edema (10 %). When excluding patients with pre-existing disease (N=115) (advanced age-related macular degeneration, prior retinal detachment, and advanced glaucoma) there was no significant differences in visual acuity and complication rates between the three groups.
In the current study, patients undergoing same-day versus PPV within one week versus vitrectomy greater than one week for retained lens fragments have similar outcomes and complication rates. Hence, same-day surgery, while logistically attractive, was not associated with better outcomes.
This PDF is available to Subscribers Only