Clinical predictors and outcomes of pars plana vitrectomy for retained lens material after cataract extraction.
OBJECTIVE
To determine current clinical predictors and visual outcomes of patients who undergo pars plana vitrectomy (PPV) for retained lens material.


METHODS
Retrospective, noncomparative, consecutive case series.


METHODS
Medical records of 166 patients with complicated cataract surgery who underwent PPV for retained lens material at Retina Vitreous Consultants of Pittsburgh between January 1, 2001 and January 1, 2007 were reviewed. Main outcome measures include final visual acuity, development of glaucoma, retinal detachments, and cystoid macular edema.


RESULTS
At the final examination, 120 patients (72.3%) had a visual outcome of 20/40 or better and 18 patients (10.8%) had a visual outcome of 20/200 or worse. In patients without any preoperative eye conditions, 82.6% achieved a final vision of 20/40 or better. Multivariable analysis showed that predictors for visual outcomes of 20/40 or better were better presenting vision (P = .001), insertion of a posterior chamber lens (P = .005), and absence of preoperative eye disease (P = .001). Predictors for visual outcomes of 20/200 or worse were the absence of an anterior vitrectomy at cataract surgery (P = .005), absence of a sulcus lens (P = .011), presence of preexisting eye disease (P = .02), and development of glaucoma (P = .001). Performing a PPV within 7 days of cataract surgery was associated with a lower risk of developing glaucoma (P = .005).


CONCLUSIONS
Current techniques for management of retained lens material may contribute to improved visual outcomes based on our series. We recommend that the cataract surgeon perform an anterior vitrectomy, place a posterior chamber lens if possible, and consult a retina specialist for a PPV within 7 days to decrease the risk of developing secondary glaucoma.
Ho
Lawrence Y
LY
University of Pittsburgh Medical Center Department of Ophthalmology, Pittsburgh, Pennsylvania, USA. ho.lawrence@gmail.com
Doft
Bernard H
BH
Wang
Li
L
Bunker
Clareann H
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005901:Glaucoma / Q000503:physiopathology; D006801:Humans; D007906:Lens Subluxation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008269:Macular Edema / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D012163:Retinal Detachment / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods*