Immediate pars plana vitrectomy improves outcome in retained intravitreal lens fragments after phacoemulsification.
OBJECTIVE
To investigate the clinical features, visual acuity outcomes and the most appropriate intervention time in patients with retained lens fragments managed by pars plana vitrectomy.


METHODS
This was a retrospective review of the records of 78 patients who underwent pars plana vitrectomy for retained lens fragments at the Tri-Service General Hospital from January 1, 2000, to December 31, 2006.


RESULTS
The mean age of the patients was 70 years (range, 24-92 years). There were 40 men (51%) and 38 women (49%). The mean follow-up period after surgery was 13.8 months. Forty-five patients (58%) had vitrectomy within 1 day of phacoemulsification (group A), 22 (28%) within 1 week (group B) and 11 (14%) after more than 1 week (group C). No patients in group A developed complications, and 76% achieved a final visual acuity of 6/12 or better. In group B, all patients had elevated intraocular pressure, and 45% achieved a final visual acuity of 6/12 or better. In group C, all patients presented with corneal edema, moderate or severe uveitis, and elevated intraocular pressure. Of these patients, 27% had cystoid macular edema, 36% developed retinal detachment, and 27% had a final visual acuity of 6/12 or better.


CONCLUSIONS
Pars plana vitrectomy performed immediately after cataract surgery for retained lens fragments is a viable option and may achieve a better visual outcome, with reduced risk of secondary glaucoma, retinal detachment or cystoid macular edema.
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Ching-Long
CL
Chen
Teng-Yi
TY
Wang
Jen-Hao
JH
Cheng
Ming-Cheng
MC
Tai
Da-Wen
DW
Lu
Jiann-Torng
JT
Chen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007906:Lens Subluxation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*