Pars plana vitrectomy for the management of retained lens material after cataract surgery

Am J Ophthalmol. 2007 Sep;144(3):364-70. doi: 10.1016/j.ajo.2007.05.027. Epub 2007 Jul 16.

Abstract

Purpose: To evaluate the management and outcomes of patients undergoing pars plana vitrectomy (PPV) for retained lens material after cataract surgery; and to evaluate risk factors for poor visual outcome, retinal detachment, raised intraocular pressure (IOP), and cystoid macular edema (CME).

Design: Retrospective interventional consecutive case series.

Methods: setting: Institutional and Clinical practice. study population: Patients with retained lens material after cataract surgery who underwent vitrectomy at Sydney Eye Hospital between July 1, 1998 and October 31, 2003. intervention: Standard three-port PPV/lensectomy. main outcome measures: Final best-corrected visual acuity (BCVA), retinal detachment, raised IOP, and CME.

Results: A total of 223 eyes of 223 patients were included, with a mean follow-up of 20.5 months after vitrectomy. Final BCVA was 6/12 or better in 159 patients (71.3%). Retinal detachment occurred in 20 patients (9%), with 11 diagnosed before or during vitrectomy, and nine occurring after vitrectomy. Ten patients (5.0%) developed raised IOP and 42 (23.2%) developed CME. Poor final visual acuity was associated with retinal detachment (P = .0026), and with poor visual acuity at presentation (P = .030). There was a significant association between retinal detachment and a long interval (>30 days) between cataract surgery and vitrectomy (P = .00047) and between retinal detachment and younger age (P = .0070).

Conclusions: Visual acuity results in this study compared favorably with previously published reports. Although the overall rate of retinal detachment was low, it was significantly higher in those with a delayed interval between cataract surgery and vitrectomy, and was significantly associated with a poorer visual outcome.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cataract Extraction / adverse effects*
  • Corneal Edema / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure / physiology
  • Intraoperative Complications*
  • Lens Subluxation / etiology
  • Lens Subluxation / surgery*
  • Macular Edema / etiology
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retinal Detachment / etiology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy / methods*