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N. Dhingra, I.A. Pearce, C. Groenewald, D. Wong; Visual Outcome After Pars Plana Vitrectomy For Posteriorly Dislocated Lens Fragments In Phacoemulsification . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1459.
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To evaluate the visual outcome of patients with posteriorly dislocated lens fragments after phacoemulsification managed with pars plana vitrectomy (PPV) and identify the risk factors associated with poor visual outcome.
The medical records of all the patents who underwent PPV for posteriorly dislocated lens fragments after phacoemulsification in one year were retrieved. Demographics, pre–existing eye conditions, details of previous cataract surgery, performance of anterior vitrectomy at initial surgery, fragment/complete nucleus drop, findings at presentation, details of the vitreoretinal procedure, final visual acuity, and complications observed during follow–up were evaluated. Univariate and multiple regression analysis were used to determine the significance of these clinical variables as determinants of poor visual outcome (visual acuity 20/40 or worse).
Seventeen eyes in 17 patients (9males and 8 females) underwent PPV for posteriorly dislocated lens fragments. Twelve eyes underwent PPV at a median time of 6 days (range 1–150 days) after cataract surgery. In the other 5 eyes it was performed on the same day. In a mean follow–up of 6.3 ± 4.3 months (range– 2–14 months), nine patients (52.9%) achieved a final visual acuity of 20/40 or better. Pre–existing eye disease (P<.01) and the position of the newly implanted IOL were the only factor found to be statistically significantly correlated with poor visual outcome. Patients implanted with anterior chamber intraocular lens had a statistically worse outcome than patients who were implanted posterior chamber or an iris claw lens. Delayed vitrectomy, use of ultrasound fragmotome and occurrence of retinal break were not associated with poor visual outcome.
Posteriorly dislocated lens fragments after cataract surgery were safely removed using PPV. Pre–existing eye disease was the only pre–operative variable resulting in poor visual outcome.
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