Abstract
Purpose: :
Posterior dislocation of the crystalline lens is a well known and feared complication of phacoemulsification. Pars plana lensectomy (PPL) is performed following this complication, but there is no clear consensus on how soon this procedure should be performed. In this study we reviewed duration between cataract surgery and PPL and its effect on visual outcomes and associated complications.
Methods: :
We performed a consecutive retrospective review of dropped nucleus following phacoemulsification performed by resident physicians from January 2003 to June 2006 at Malcom Randall VA Medical Center in Gainesville, Florida. We divided the cohort based on the duration between cataract surgery and pars plana lensectomy (PPL): same day surgery (Group 1), less than 1 week (Group 2), and equal or greater than 1 week (Group 3). We measured the best corrected visual acuity before surgery and after surgery at months 1, 3, 6, 9 and 12. The number of additional surgeries performed and rate of retinal detachment in each cohort was compared. The visual outcome was compared based on line changes on Snellen vision chart and vision groupings.
Results: :
Twenty-three cases of dropped nucleus that underwent PPL were identified from January 2003 to June 2006. Of these 5 cases (22%) had PPL performed on the same day, 7 cases (30%) within 1 week, and 11 cases (48%) after 1 week. There was no significant age difference between these groups. There was no statistically significant difference between cohorts when comparing vision before surgery to final best corrected visual acuity. When comparing visual outcome based on vision groupings there was no statistically significant difference between the groups; however the rate of retinal detachment (RD) during the study time was 60% in Group 1 and 14% in Group 2 (p = <0.001). There were no cases complicated with retinal detachment in Group 3.The group that underwent same day surgery (Group 1) had a higher average number of additional surgeries when compared to the other groups.
Conclusions: :
Although there was no statistically significant difference in visual outcome based on duration between attempted cataract extraction and PPL, the rate of cases complicated with RD was highest with the same day surgery group. The rate of RD decreased with the longer duration between cataract surgery and PPL.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • cataract • retinal detachment