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Melissa Wong, Edward B. Feinberg, Deeba Husain, Manju L. Subramanian, Steven Ness; Visual Acuity and Intraocular Pressure Outcomes Following Pars Plana Vitrectomy and Lensectomy for Retained Lens Fragments After Complicated Cataract Extraction. Invest. Ophthalmol. Vis. Sci. 2011;52(14):533.
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To determine visual acuity (VA) and intraocular pressure (IOP) outcomes in patients undergoing pars plana vitrectomy and lensectomy for retained lens fragments (RLF) following complicated cataract extraction.
This is a retrospective chart review of patients who underwent pars plana vitrectomy and lensectomy for retained lens fragments at Boston Medical Center from January 1, 2005 to January 1, 2010. Data from preoperative and postoperative clinical visits as well as operative reports were reviewed. The primary endpoint of the study is final visual acuity. The secondary endpoint is the new diagnosis of glaucoma during follow-up.
Sixty-nine eyes were included in the study. Average duration of follow-up was 21.13 months (range 3-108). Average final visual acuity was logMAR 0.6, range 0 - NLP (Snellen equivalent 20/80, range 20/20 - NLP). Thirty-five patients (50.1%) achieved final visual acuity better than logMAR 0.31 (Snellen equivalent 20/40), and in 12 patients (17.4%) final visual acuity was worse than logMAR 1.0 (Snellen equivalent 20/200). Final visual acuity was significantly worse in patients with duration of retained lens fragment of greater than 7 days (p=0.05). Patients with a preoperative history of glaucoma were more likely to have final acuity worse than logMAR 1.0 (p=0.06). A new diagnosis of glaucoma occurred in 11 of 52 patients (21.2%) without a history of glaucoma. There was a trend towards a higher rate of new glaucoma diagnosis in diabetic vs. non-diabetic patients, although it failed to reach statistical significance (p=0.09).
In this study of 69 patients treated with pars plana vitrectomy and lensectomy for retained lens fragments, 50.1% of patients achieved final visual acuity better than logMAR 0.31 (Snellen equivalent 20/40). A shorter duration of retained lens fragment resulted in a significantly improved final visual acuity outcome. A new diagnosis of glaucoma was made in 21.2% of patients during the course of follow-up.
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