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JK Moore, IU Scott, HW Flynn, TG Murray, WE Smiddy, R Jorge, MB Pereira, JE Kim, NF Vilar; Retinal Detachment in Eyes Undergoing Pars Plana Vitrectomy for Removal of Retained Lens Fragments . Invest. Ophthalmol. Vis. Sci. 2002;43(13):633.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the incidence and outcomes of retinal detachment (RD) associated with retained lens fragments removed by pars plana vitrectomy (PPV). Method: Retrospective, noncomparative, consecutive case series. Participants included all patients who underwent PPV at Bascom Palmer Eye Institute between January 1, 1990 and December 31, 2000 for retained lens material after cataract surgery. Demographic and clinical data were extracted from patients' medical records. Results: RD occurred in 44/303 (14.5%) patients, including 25 (8.3%) before or during PPV and 19 (6.3%) after PPV. The RD was macula-on in 22/44 (50%) patients and macula-off in 22/44 (50%). The RD was associated with a giant retinal tear in 7/44 (15.9%) patients, suprachoroidal hemorrhage in 3/44 (6.8%), and endophthalmitis in 4/44 (9.1%). Retinal reattachment was achieved in 40/44(90.9%); 14/44 (31.8%) patients underwent one or more additional procedures for recurrent detachment. Final visual acuity in the patients in this series was ≷20/40 in 8/44 (18.2%), 20/50-20/100 in 11/44 (25.0%), 20/200 - 5/200 in 12/44(27.3%) and <5/200 in 13/44 (29.5%). In the 36 patients with vision less than 20/40, primary causes of decreased vision included prior history of RD 8/36 (22.2%), corneal edema in 7/36 (19.4%), cystoid macular edema in 5/36 (13.9%), persistent retinal detachment 4/36 (11.1%), pre-existing primary open angle glaucoma in 4/36 (11.1%), age-related macular degeneration in 3/36 (8.3 %), epiretinal membrane in 2/36 (5.5%), macular hole in 1/36 (2.7%), optic atrophy in 1/36 (2.7%), and irregular astigmatism 1/36 (2.7%). Conclusion: RD in eyes undergoing PPV for removal of retained lens fragments is a frequent event. Despite favorable retinal reattachment rates, visual acuity outcomes are often poor in these eyes and are frequently associated with other comorbidities such as corneal edema and cystoid macular edema.
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