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Seung Lee; Comparison of outcomes between 20, 23 and 25 gauge vitrectomy for dropped lens fragments during cataract surgery.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):845. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the outcomes of 20, 23, 25 gauge(G) pars plana vitrectomy (PPV) for lens fragment dropped into vitreous cavity during cataract surgery.
This was a comparative, retrospective, interventional case series study, the medical chart were reviewed. One-hundred seventeen eyes of 117 patients with dropped lens fragments into the vitreous underwent PPV from March 1, 2010 to July 31, 2017. Thirty-one, 52, and 34 eyes underwent 20G PPV, 23G PPV, 25G PPV, repsectively. The analysis included charaacteristics of the patients, visual acuity, opertion times, and rate of complications.
The mean interval between Preoperative characteristics were similar in the 3 groups. The mean interval between cataract surgery and PPV was 0.58±1.1 days, and all of PPV were performed within 4 days after cataract surgery. The mean best-corrected visual acuity(logMAR) improved from 1.42 ± 0.78 to 0.21±0.15 (p = 0.00), from 1.34 ± 0.87 to 0.43±0.62 (p = 0.013) and from 1.91 ± 0.59 to 0.42 ± 0.51(p = 0.00) with 20, 23, and 25-G systems, respectively. The size of the lens and mean operation time were found to have a positive correlation(R2 = 0.86, P<0.01). Modified PFCL technique(lens fragments floated to the iris plane and was removed using phacoemulsification) was used in twenty eyes(12 cases: 23G group, 8 cases: 25G group). The time of operation was significantly lower in the 23G and 25G group than in the 20G group (P = 0.03). There were no cases of post-operative hypotony or endophthalmitis seen. Retinal detachment developed in 2 patients (6.4%), occurring only in patients of 20G group.
It is considered that 23G and 25G MIVS for lens fragments dropped into the vitreous cavity during cataract surgery can be a safe and effective way for dropped lens fragments of modest size.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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