Vitrectomy for retained lens material after cataract extraction: the relationship between histopathologic findings and the time of vitreous surgery.
OBJECTIVE
To report the histopathologic features of vitreous specimens obtained after vitrectomy for retained lens material and to correlate these findings with the time after cataract surgery at which vitreous surgery was performed.


METHODS
Observational case series.


METHODS
All 135 patients who had vitreous specimens submitted to the pathology laboratory after vitreous surgery for retained lens material after elective senile cataract surgery.


METHODS
A review of histopathologic reports of 135 consecutive vitreous specimens that were obtained during vitreous surgery for retained lens material after surgery for senile cataract.


METHODS
Identification of lens material, macrophages, phacolytic cells, and giant cells in the vitrectomy specimens.


RESULTS
Lens material was observed in 100% of cases. Macrophages without ingested lens material were present in 48% (65 of 135), phacolytic cells in 24% (32 of 135), and a mixture of neutrophils and multinucleated giant cells in 8% (11 of 135). No cells were discovered in eyes in which vitrectomy was performed within 3 days of cataract extraction. The percentages of eyes with macrophages increased from 35% when vitrectomy was performed 4 to 7 days after cataract surgery to 80% when this time interval was 61 to 90 days.


CONCLUSIONS
Lens-induced inflammatory reaction seems to increase with time that retained lens material remains in the eye.
Wilkinson
C P
CP
Eye Pathology Laboratory, The Wilmer Ophthalmological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-9248, USA.
Green
W R
WR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D007906:Lens Subluxation / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D007908:Lens, Crystalline / Q000473:pathology* / Q000601:surgery; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014821:Vitrectomy