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L. C. Olmos, H. W. Flynn, Jr., P. Gallogly, W. E. Smiddy, T. G. Murray, J. L. Davis; Clinical Features and Outcomes of Pars Plana Vitrectomy for Retained Lens Fragments: Same- Day Surgery versus Delayed Surgery. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5573.
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To investigate the clinical features, visual acuity outcomes, and retinal detachment rates in patients with retained lens fragments managed by pars plana vitrectomy (PPV). To compare the clinical outcomes of patients who underwent same-day PPV versus delayed PPV.
This is a retrospective consecutive case series in which all consecutive cases of retained lens fragments that underwent PPV over an 18-year period (1990-2007) were reviewed. Clinical data was collected, including postoperative retinal detachment rates and visual acuity outcomes. All patients with retinal detachment noted before, during, or after PPV were included in the study. Cases were divided into three groups: 1) those in which PPV was performed on the same day as cataract surgery (n = 64); 2) those in which PPV was performed within one week of cataract surgery (n = 108); and 3) those in which PPV was performed greater than one week after cataract surgery (n = 266). The clinical features of each group were compared.
The retinal detachment rate was 11.8% overall. Retinal detachment rates for the three subgroups were the following: 7.8% (5/64), 11.1% (12/108), and 13.2% (35/266) for cases that underwent PPV on the same day, within one week, and after one week, respectively. This difference was not statistically significant (p = 0.48). There was no significant difference in median last follow-up acuity among cases in which an RD did not occur, regardless of time to surgery (p=0.68). This visual acuity was 20/30 for each subgroup. Similarly, there was no significant difference in median last follow-up acuity among cases in which an RD did occur (p=0.94). The median visual acuity was 20/100 for these patients.
Pars plana vitrectomy and removal of retained lens fragments results in improved visual acuity for many patients. Visual acuity outcomes were better in eyes that did not develop retinal detachment during their course of follow-up. Early intervention may allow for more optimal visual outcomes. Although patients who received earlier surgical intervention had lower retinal detachment rates, this difference was not statistically significant.
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