Abstract
Purpose :
To compare time to surgery outcomes of 23-gauge endoscopy assisted pars plana vitrectomy (E-PPV) after cataract extraction surgery complicated with dropped lens fragments.
Methods :
A retrospective chart review was done on patients diagnosed with residual lens fragments after cataract extraction surgery at Kansas University Medical Center over the last 10 years and received a subsequent E-PPV. A straight ophthalmic endoscope was used through a 23-gauge cannula in all patients. Time to surgical intervention subgroups were divided into: (a) within 24-hours or later, (b) within 3 days or later, and (c) within 7 days or later. Patients who were not compliant with post-operative care were excluded. Data collection included LogMAR visual acuity (VA), age, gender, and post-operative complications. The institutional review board of the University of Kansas School of Medicine approved this study.
Results :
10 patients met the study inclusion criteria (5 females, and 5 males), with an average age of 66±9.8 years old. The average postoperative LogMAR VA for all patients was 2.13±0.76 on the first postoperative day (POD#1), 1.73±0.9 after 1 week, and 1.3±1.1 after 1 month. In patients with good visual potential, E-PPV done within 24-hours resulted in a better average POD#1 LogMAR VA compared to a later intervention time (1.15 and 2.26, respectively) (p-value: 0.038). This difference disappeared after 1 week. There was no significant difference in average POD#1 LogMAR VA when E-PPV was done within 3 days compared to later than 3 days following the cataract surgery (2.08 and 2.48, respectively) (p-value: 0.17), or when E-PPV was done within 7 days compared to later than 7 days (2.25 and 2.35, respectively) (p-value: 0.4). There was no significant difference in average postoperative intraocular pressure between subgroups. Postoperatively, 1 patient had cystoid macular edema at 1 month that required treatment with topical eye drops.
Conclusions :
In this study, patients who received E-PPV within 24-hours demonstrated significantly better early visual recovery compared to the later than 24-hours intervention subgroup, however the difference disappeared after 1 week. There was no significant VA outcome difference within the 3 days or the 7 days intervention time groups. Prospective trials are needed to better define E-PPV intervention time role in similar patients.
This is a 2020 ARVO Annual Meeting abstract.