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G.A. Salam, J.M. Greene, V.A. Deramo, P.J. Ferrone, D.M. Fastenberg; INCIDENCE, MANAGEMENT, AND VISUAL OUTCOME IN PATIENTS WITH RETINAL TEARS AND RHEGMATOGENOUS RETINAL DETACHMENT DEVELOPING AFTER CATARACT EXTRACTION COMPLICATED BY POSTERIORLY DISLOCATED LENS MATERIAL . Invest. Ophthalmol. Vis. Sci. 2004;45(13):302.
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Purpose:To evaluate the incidence, management, and effect on visual acuity of retinal tears (without retinal detachment) and rhegmatogenous retinal detachment in patients with posteriorly dislocated lens fragments after cataract extraction. Methods:Retrospective consecutive series of patients presenting with posteriorly dislocated lens material after cataract extraction. Results:A total of 307 patients with posteriorly dislocated lens material after cataract extraction were identified. Two hundred and forty nine patients (81%) underwent pars plana vitrectomy (PPV) for removal of the lens material. Thirty eight patients (12%) developed retinal tears, 25 of whom were noted to have rhegmatogenous retinal detachment. Retinal tears/detachment was detected at or before PPV in 19 patients and after PPV in the other 19 patients. All eyes with retinal tears were treated with laser photocoagulation/cryopexy. Management options for retinal detachment included office pneumatic retinopexy, scleral buckle, and/or gas tamponade at the time of PPV. Out of total 307 eyes, 168 (55%) achieved a final visual acuity of 20/40 or better. Seven of the 13 eyes (54%) with retinal tears (without retinal detachment) achieved a final visual acuity of 20/40 or better. In the retinal detachment group, 9 of the 16 macula on eyes (56%) achieved a final visual acuity of 20/40 or better, whereas all 9 eyes with macula off had a final visual acuity of 20/200 or worse. Conclusions:Retinal tears and rhegmatogenous retinal detachment are significant complications in patients with posteriorly dislocated lens material following cataract extraction. A good visual outcome is possible in eyes with posteriorly dislocated lens fragments after cataract extraction, even when retinal tears are present. The presence of macula off retinal detachment, however, adversely affects the visual outcome.
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