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L. C. Olmos, P. M. Gallogly, H. W. Flynn, Jr., W. E. Smiddy, T. G. Murray; Clinical Features and Outcomes of Pars Plana Vitrectomy for Retained Lens Fragments Over an 18-Year Period. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6001. doi: https://doi.org/.
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To investigate the clinical features, visual acuity outcomes, and adverse events in patients with retained lens fragments managed by pars plana vitrectomy (PPV).
All consecutive cases of retained lens fragments that underwent PPV over an 18 year period (1990-2007) were reviewed. To study whether post vitrectomy outcomes had changed, these cases were divided into two nine year groups. Cases were reviewed for postoperative retinal detachment, visual acuity, intraocular pressure elevation, and cystoid macular edema (CME).
The current study identified 516 cases. The cases were divided into two groups as follows: those receiving vitrectomy between 1990 and 1998, n = 269 (52%); and those receiving vitrectomy between 1999 and 2007, n = 247 (48%). There was a trend toward a decrease in percent of cases with post-operative intraocular pressure ≥30. However, there was a trend toward an increase in CME in the latter 9-year period, possibly due to the advent of OCT as a diagnostic tool. The number of days from cataract surgery to vitrectomy tended to decrease over the study period, and there was a trend for a decreased rate of post-vitrectomy retinal detachments in the latter group. Better postoperative visual acuities were associated with a less complicated clinical course, including no retinal detachment, suprachoroidal hemorrhage, or cystoid macular edema.
Retained lens fragments after cataract surgery is a common clinical problem. Pars plana vitrectomy and removal of retained lens fragments results in improved visual acuity and lower intraocular pressure. Better visual outcomes are associated with a less complicated clinical course. Less aggressive vitrectomy at the time of cataract surgery and earlier referral to a vitreoretinal surgeon may be associated with lower rates of retinal detachment.
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