Preservation of anterior capsule during vitrectomy and lensectomy for retinal detachment with proliferative vitreoretinopathy.
OBJECTIVE
To report a series of 15 eyes with rhegmatogenous retinal detachment and proliferative vitreoretinopathy (PVR) or at high risk for advanced PVR, which underwent pars plana vitrectomy (PPV) and lensectomy (PPL) with preservation of the anterior capsule.


METHODS
Retrospective noncomparative case series.


METHODS
Fifteen consecutive patients with retinal detachment and varying degrees of PVR in one eye.


METHODS
All eyes had undergone PPV and PPL with preservation and polishing of the anterior capsule and had at least 6 months of follow-up. Of the 15 eyes, grade C PVR was present preoperatively in 11 and was anterior in 5. Seven of 15 eyes had gas and 8 of 15 had silicone oil tamponade. Eight of 15 eyes had subsequent posterior chamber intraocular lens (PCIOL) placement; 5 eyes had simultaneous silicone oil removal. One eye had a PCIOL placed at the time of the PPL.


METHODS
Visual acuity, retinal reattachment, complications of gas or silicone oil tamponade, and anterior capsular clarity.


RESULTS
Fourteen eyes had complete retinal reattachment at the final visit (1 of 15 had macular redetachment only). Final visual acuity was better or equal to preoperative acuity in all eyes, improving by 4 +/- 4 lines overall. No eyes had corneal decompensation, pupillary block, or other vision-threatening anterior segment complication. The anterior capsule remained centrally clear in the 13 eyes that did not have a primary central capsulotomy. One eye with minimal preoperative PVR developed hypotony.


CONCLUSIONS
Vitreoretinal surgeons can preserve the anterior capsule in eyes with retinal detachment and PVR to help prevent intraoperative and postoperative complications of gas or silicone oil, simplify future PCIOL placement, and maintain a normal iris appearance.
MacCumber
Mathew W
MW
Department of Ophthalmology, Rush Medical College of Rush University, Chicago, Illinois, USA.
Packo
Kirk H
KH
Civantos
Joseph M
JM
Greenberg
Jason B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007903:Lens Capsule, Crystalline / Q000502:physiology*; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000627:therapeutic use; D014792:Visual Acuity; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000601:surgery*
D012827:Silicone Oils