Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments.
OBJECTIVE
To investigate the incidence and outcomes of retinal detachment (RD) associated with retained lens fragments removed by pars plana vitrectomy (PPV).


METHODS
Retrospective, noncomparative, interventional consecutive case series.


METHODS
All patients who underwent PPV for retained lens material after cataract surgery at Bascom Palmer Eye Institute between January 1, 1990, and December 31, 2001.


METHODS
Demographic and clinical data were extracted from patients' medical records.


METHODS
Incidence of retinal detachment, reattachment rate, and visual acuity outcome.


RESULTS
RD occurred in 44 of 343 (12.8%) patients, including 25 (7.3%) before or during PPV and 19 (5.5%) after PPV. The RD was macula-on in 22 of 44 (50%) patients and macula-off in 22 of 44 (50%) patients. The RD was associated with a giant retinal tear in 7 of 44 (15.9%) patients, limited suprachoroidal hemorrhage in 3 of 44 (6.8%) patients, and endophthalmitis in 4 of 44 (9.1%) patients. Retinal reattachment was achieved in 40 of 44 (90.9%) patients; 14 of 44 (31.8%) patients underwent one or more additional procedures for recurrent detachment. Final visual acuity in the patients in this series was >/=20/40 in 8 of 44 (18%), 20/50 to 20/100 in 13 of 44 (30%), 20/200 to 5/200 in 13 of 44 (30%), and <5/200 in 10 of 44 (23%). In the 36 patients with vision less than 20/40, the primary causes of decreased vision were attributed to prior history of RD in 8 of 36 (22.2%), corneal edema in 7 of 36 (19.4%), cystoid macular edema in 5 of 36 (13.9%), persistent retinal detachment in 4/36 (11.1%), preexisting primary open-angle glaucoma in 4 of 36 (11.1%), age-related macular degeneration in 3 of 36 (8.3%), epiretinal membrane in 2 of 36 (5.5%), macular hole in 1 of 36 (2.7%), optic atrophy in 1 of 36 (2.7%), and irregular astigmatism in 1 of 36 (2.7%) patients.


CONCLUSIONS
RD is a frequent complication in eyes undergoing PPV for removal of retained lens fragments. Despite favorable retinal reattachment rates, visual acuity outcomes are often poor in these eyes and are associated with other comorbidities such as corneal edema and cystoid macular edema. Poor initial visual acuity and the presence of a retinal tear at the time of PPV were associated with a higher rate of RD after PPV.
Moore
Jeffrey K
JK
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA.
Scott
Ingrid U
IU
Flynn
Harry W
HW
Smiddy
William E
WE
Murray
Timothy G
TG
Kim
Judy E
JE
Vilar
Nancy F
NF
Pereira
Mauricio B
MB
Jorge
Rodrigo
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002832:Choroid Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D009877:Endophthalmitis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D007906:Lens Subluxation / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D012167:Retinal Perforations / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D014821:Vitrectomy