Purchase this article with an account.
C.J. Chen, A. Monroe, H. Wafapoor, M.S. Romero; Surgical Results of Retained Lens Fragments by Radical Vitrectomy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):2006.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: Retained lens fragments following cataract extraction can cause serious ocular problems. This study seeks to evaluate the clinical outcomes when a more complete vitrectomy and a more careful handling of the vitreous base are performed during the removal of these fragments. Materials and Methods: The authors conducted a retrospective chart review of 44 eyes in 43 patients who had retained lens fragments following the cataract surgery under the care of the Retinal Division of the Department of Ophthalmology at the University of Mississippi Medical Center between January 2000 and July 2003 . All patients received a complete trans pars plana vitrectomy including posterior hyaloid membrane removal and vitreous base shaving following the proportional phakofragmentation to remove the retianed lens fragements. Results: Patients were followed for periods ranging from 1 month to 30 months with an average follow–up time of 10.7 months. Presenting pre–operative symptoms included the following: glaucoma in 27 patients (61.4%); uveitis in 31 patients (70.5%); corneal edema in 29 patients (65.9%); choroidal effusions in 2 patients (4.5%); and retinal detachment in 2 patients (4.5%). Post–operatively, 13 patients (29.5%) had glaucoma requiring medication. Uveitis and corneal edema resolved in all cases. Retinal detachments were identified after vitrectomy in 2 of the 44 patients (4.5%). Initial visual acuity was better than or equal to 20/40 in 4.7%, between 20/40 and 20/100 in 11.6%, between 20/100 and 20/200 in 20.9%, and worse than 20/200 in 62.8%. Post–operatively 51.2% of patients had visual acuities of 20/40 or better, 11.6% fell between the range of 20/40 to 20/100, 9.3% achieved visual acuities of 20/100 to 20/200, and 27.9% had visual acuities of worse than 20/200. Conclusions: A radical vitrectomy with a more careful vitreous base handling and posterior hyaloid membrane removal following the proportional phakofragmentation for the retained lens fragments after the cataract surgery can resulted in a satisfactory postoperative outcome. Preoperative uveitis and corneal edema have resolved completely in all cases. More than 50% of preoperative glaucoma are controlled without medication after vitrectomy. Incidence of retinal detachment has reduced and majority of patients have significant visual improvement.
This PDF is available to Subscribers Only