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zine Elhousseini, Edward Lee, Tom H Williamson; Incidence of lens touch during pars plana vitrectomy and outcomes from subsequent cataract surgery. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2313.
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© ARVO (1962-2015); The Authors (2016-present)
To establish the incedince of lens touch during pars plana vitrectomy, and whether leads to increased complications rate in subsequent cataract surgery
Data from all patients attending three centers for vitreoretinal surgery,prospectively entered into electronic patient record (VITREOR).Patients with pseudophakia or aphakia, or patients who were scheduled for combined cataract surgery at the time of pars plana vitrectomy were excluded. The records of all phakic patients undergoing PPV (without combined cataract surgery) from January 2001 to March 2013 were analyzed. Patients undergoing subsequent cataract surgery were identified and case notes were reviewed where necessary. Cataract surgeries in patients who had had prior lens touch during their first vitrectomy were compared with a control group who had also undergone vitrectomy and then subsequent cataract surgery, but with no recorded lens touch. Lens bite with the cutter is considered as a separate entity and was excluded as a lens touch in this study. Analysis of the study was performed on Microsoft office Excel 2007 software and Analyse-it software (Cambridge UK).
A total of 1400 Pars Plana Vitrectomy operations of phakic eyes, eligible for the inclusion criteria of the study for the period between January 2001 and April 2013, were analyzed. 54 patients had a lens touch (3.8%). Most of the operations in which a Lens Touch occurred where retinal detachments repair (52.5%),and no statistical significant was found, but using silicon oil and PVR peel where significant for causing lens touch. Cataract developed in 49 patients (90.7%) and only 45 patients had a cataract surgery, while the rest lost to follow up or no surgery. Cataract surgery in 43 patients (86%) had no complications, posterior capsule (PC) rupture happened in 5 patients (11%) and in 4 patient (4%) instability of the zonules was noted before the cataract operation, the PC rupture rate was significantly higher compared to the control group of cataract surgery in vitroctumized eyes with no lens touch. most of the patients achieved >0.3 LogMar visual acuity.
Lens touch during pars plana vitrectomy has a higher incident than reported. Lens Touch in Vitrectomy has significant risk factor for PC rupture during the subsequent cataract surgery, and such cases should be documented and performed with great care and preferably by the Vitreo-Retinal Team.
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