Vitrectomy and lensectomy in the management of posterior dislocation of lens fragments.
OBJECTIVE
To study the visual results and complications in patients treated by vitrectomy and lensectomy for posterior dislocation of lens fragments during phacoemulsification.


METHODS
University Hospital of Wales, Cardiff, United Kingdom.


METHODS
This retrospective study was carried out between 1995 and 1998. Eighteen patients had a vitrectomy and lensectomy for posterior dislocation of lens fragments. The referral patterns, the presenting features, and the complications were recorded. The patients were invited for a final review to assess and record the final visual outcome and for a detailed ocular examination.


RESULTS
The median age of the patients was 76 years. The youngest patient was 62 years and the oldest, 87 years. The median time of referral was 1 day (range 0 to 67 days). The median timing of the surgery was 6 days (range 2 to 77 days); however, 5 patients had a vitrectomy-lensectomy performed at the time of cataract surgery (day 0). Uveitis was present in 100% of patients, corneal edema in 76.0%, and ocular hypertension in 38.4%. Median follow-up was 12 months (range 6 to 34 months). Visual acuity was 6/12 or better in 83.3% of patients. Two patients were treated for retinal tears, 2 had postoperative uveitis, 2 had macular pucker, and 2 had ocular hypertension. There was no statistically significant association between final visual outcome and grade of the surgeon performing the cataract operation, the presence of an intraocular lens at the time of cataract surgery, the timing of the vitrectomy-lensectomy, or the presence of previtrectomy uveitis or high intraocular pressure (IOP).


CONCLUSIONS
Early recognition of dislocated lens fragments and prompt assessment for vitrectomy-lensectomy produced excellent visual results and few complications. The corneal edema, uveitis, and high IOP resolved with the vitrectomy-lensectomy.
Watts
P
P
Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK. patrick.watts@net.ntl.com
Hunter
J
J
Bunce
C
C
D000368:Aged; D000369:Aged, 80 and over; D000867:Anterior Chamber / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D007906:Lens Subluxation / Q000209:etiology / Q000601:surgery*; D007908:Lens, Crystalline / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012086:Reoperation; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy