title: Same-day versus delayed vitrectomy with lensectomy for the management of retained lens fragments.
abstract: OBJECTIVE
  To evaluate whether performing same-day pars plana vitrectomy versus delayed pars plana vitrectomy affects visual outcomes and ocular morbidity of patients with retained lens fragments after a complicated cataract surgery.
  
  
  METHODS
  Retrospective, comparative case series of 172 eyes of 171 patients with retained lens fragments undergoing 3-port pars plana vitrectomy using 20-, 23-, or 25-gauge instrumentation between 2005 and 2008. Outcome measures included best-corrected visual acuity at 6 months, final best-corrected visual acuity, and postoperative complications such as cystoid macular edema, intraocular pressure elevation, retinal detachment, vitreous hemorrhage, choroidal hemorrhage, and endophthalmitis.
  
  
  RESULTS
  The median age was 75 ± 0.8 years. The mean time to vitrectomy for the delayed group was 15 ± 2 days. The preoperative logarithm of the minimum angle of resolution best-corrected visual acuity for immediate vitrectomy was 0.73 ± 0.09 versus 0.72 ± 0.06 for delayed vitrectomy. Six-month logarithm of the minimum angle of resolution acuity was 0.44 ± 0.09 for same-day vitrectomy compared with 0.44 ± 0.05 for delayed vitrectomy (P = 0.97, 2-tailed t-test). Of 59 eyes undergoing immediate vitrectomy, 17 (29%) experienced postoperative complications, while 38 of 113 eyes (34%), experienced complications if undergoing delayed vitrectomy (Fisher exact test, P = 0.61). Overall, the most common complication was cystoid macular edema occurring in 25 of 172 eyes (15%).
  
  
  CONCLUSIONS
  The outcomes of same-day pars plana vitrectomy appear to be similar to non-same-day pars plana vitrectomy. The risks and benefits related to the timing of vitrectomy after a complicated cataract surgery should be carefully discussed with each patient. Further investigation is warranted to establish an optimal time for surgical planning.
authors.affiliation: The Retina Group of Washington, Chevy Chase, Maryland, USA. colyer_m@yahoo.com
authors.forename: Marcus H
authors.initials: MH
authors.lastname: Colyer
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Berinstein
authors.forename: Noureen J
authors.initials: NJ
authors.lastname: Khan
authors.forename: Eric D
authors.initials: ED
authors.lastname: Weichel
authors.forename: Michael M
authors.initials: MM
authors.lastname: Lai
authors.forename: William F
authors.initials: WF
authors.lastname: Deegan
authors.forename: Reshma C
authors.initials: RC
authors.lastname: Katira
authors.forename: William B
authors.initials: WB
authors.lastname: Phillips
authors.forename: Reginald J
authors.initials: RJ
authors.lastname: Sanders
authors.forename: Richard A
authors.initials: RA
authors.lastname: Garfinkel
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007906:Lens Subluxation / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*