Pars plana lensectomy combined with pars plana vitrectomy for dislocated cataract.
OBJECTIVE
To assess the prognosis and complications after pars plana vitrectomy (PPV) combined with lensectomy as a primary procedure for visual correction of complicated cataract.


METHODS
Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.


METHODS
This retrospective study reviewed the preoperative, intraoperative, and postoperative clinical features in eyes that had PPV combined with lensectomy as a primary procedure for complicated cataract without severe posterior segment pathology (study group). The corrected distance visual acuity (CDVA), reoperations, retinal detachment (RD), and cystoid macular edema (CME) were ascertained. Results were compared with those in a control group of eyes having combined PPV and lensectomy for uncomplicated cataract.


RESULTS
In the study group (40 patients), 23 eyes had traumatic lens dislocation, 12 had Marfan syndrome, 7 had idiopathic lens dislocation, and 4 had pseudoexfoliation syndrome. The median corrected distance visual acuity improved from 20/185 (range 20/20 to hand motions) preoperatively to 20/30 (range 20/20 to hand motions) 3 months postoperatively (P<.001). The postoperative CDVA was poorer in cases with an etiology of trauma (P = .018). Complications included RD (6.5%), transient vitreous hemorrhage (13.0%), choroidal detachment (4.3%) and CME (13.0%), which occurred more frequently in eyes with a history of trauma (P = .022). The control group (43 eyes; 42 patients) had 1 (2.3%) RD.


CONCLUSIONS
Pars plana vitrectomy with lensectomy yielded favorable visual outcomes in eyes with complicated cataract in which standard anterior segment techniques were prohibitive or risky. However, preexisting conditions and postoperative complications may limit visual outcomes.


BACKGROUND
Neither author has a financial or proprietary interest in any material or method mentioned.
Oh
Jaeryung
J
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Smiddy
William E
WE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications*; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D007906:Lens Subluxation / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult