title: PARS PLANA VITRECTOMY AND LENSECTOMY FOR ECTOPIA LENTIS WITH AND WITHOUT THE INDUCTION OF A POSTERIOR VITREOUS DETACHMENT.
abstract: OBJECTIVE
  Posterior hyaloid removal during pars plana vitrectomy and lensectomy for ectopia lentis is commonly performed, but may increase the risk of intraoperative retinal breaks and postoperative retinal detachment. This study evaluated outcomes after pars plana vitrectomy and lensectomy with or without posterior hyaloid removal.
  
  
  METHODS
  This retrospective observational cohort study included ectopia lentis cases that underwent pars plana vitrectomy and lensectomy (2005-2014), with or without intraoperative induction of a posterior vitreous detachment (PVD). The primary outcome was postoperative retinal detachment. The secondary outcomes were the incidence of iatrogenic retinal breaks, and change in visual acuity.
  
  
  RESULTS
  Twenty-six cases were included. The posterior hyaloid was preserved intraoperatively in 11 cases (non-PVD group). In the remainder (15 cases), the vitreous was removed completely (PVD group). Postoperative retinal detachment occurred in 2 cases in each group (18.2% non-PVD vs.13.3% PVD, P = 0.7). Intraoperative breaks occurred more frequently in the PVD group (2 vs. 9 cases; P = 0.03). There was no difference in mean improvement in visual acuity (7 [PVD] vs. 3 [non-PVD] ETDRS lines; P = 0.2).
  
  
  CONCLUSIONS
  The preservation of posterior hyaloid attachment during vitreolensectomy for ectopia lentis was associated with fewer iatrogenic retinal breaks. Postoperative retinal detachment did not seem to be influenced by the choice of surgical technique.
authors.affiliation: Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom. M. S. Singh is now with the Retina Division, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Singh
authors.affiliation: Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Casswell
authors.affiliation: Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Boukouvala
authors.affiliation: Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom. P. Petrou is now with the Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Petrou
authors.affiliation: Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom.
authors.forename: David G
authors.initials: DG
authors.lastname: Charteris
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004479:Ectopia Lentis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007908:Lens, Crystalline / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000175:diagnosis / Q000209:etiology*; D012167:Retinal Perforations / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*; D020255:Vitreous Detachment / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult