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Justin H. Townsend, Lisa C. Olmos, Harry W. Flynn, Jr., William E. Smiddy, Timothy G. Murray; Clinical Features and Outcomes of Same-Day versus Delayed Pars Plana Vitrectomy for Retained Lens Fragments. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6112.
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To investigate the clinical features, visual acuity (VA) outcomes, and retinal detachment (RD) rates in patients with retained lens fragments (RLF) managed by pars plana vitrectomy (PPV) on the same day as initial cataract surgery. To compare the clinical outcomes of these patients who underwent same-day PPV versus patients undergoing delayed PPV.
All consecutive cases of RLF that underwent PPV over a 20-year period (1990-2009) at a single institution were reviewed for clinical features including VA, presence of postoperative RD and long-term complications. Cases were divided into three groups: group 1 included cases in which PPV was performed on the same day as cataract surgery; group 2 included cases in which PPV was performed between one day and one week after initial cataract surgery; group 3 included cases in which PPV was performed greater than one week after initial cataract surgery. To assess for affect of evolving surgical techniques, the 3 groups were further divided into 2 sub-groups: A) cases presenting 1990-1999; and B) cases presenting 2000-2009.
Four hundred thirty-eight eyes of 438 patients met inclusion criteria. Group 1 included 64 eyes. Group 2 included 108 eyes. Group 3 included 266 eyes. The retinal detachment rate for group 1 was 7.8%, group 2 was 11.1%, and group 3 was 13.2% (P=0.48). Median last follow-up VA in cases in which an RD did not occur was not significantly different across all groups (20/30 for all groups). Median last follow-up VA among cases in which an RD did occur was not significantly different (group 1: 20/70; group 2: 20/200; group 3: 20/100). The primary causes of decreased vision were CME, RD and corneal edema for all groups; the rates of these were not significantly different across groups. There was no significant difference between the VA outcomes of cases managed in the present versus previous decade.
Retinal detachment rates in patients with RLF are relatively high. Same-day vitrectomy does not appear to significantly improve long-term visual outcome or RD rates when compared to delayed vitrectomy.
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