Retina-Vitreous
2007 , Vol 15 , Num 2
Outcomes of Pars Plana Vitrectomy For Retained Lens Materials After Phacoemulsification Surgery
1Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Uz. Dr.2Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul, Doç. Dr. Purpose: To evaluate risk factors, clinical features, the anatomic and visual outcomes of patients with retained lens fragments removed by pars plana vitrectomy (PPV).
Materials and Methods: Fifty five consecutive eyes of 55 patients with retained lens fragments who underwent PPV between June 2001-December 2004 were reviewed retrospectively.
Results: Five patients had PPV on the same day as the cataract extraction and did not have initial outpatient examination records. Of the 50 patients, 42 (84%) had an initial visual acuity of 20/400 or worse. Ocular findings on presentation included significant intraocular inflammation in 18 eyes (36%), increased intraocular pressure in 15 eyes (30%), corneal oedema in 21 eyes (42%), retinal detachment in 6 eyes (12%), vitreous haemorrhage in 3 eyes (6%), and choroidal detachment in 3 eyes (6%). Rhegmatogenous retinal detachment developed in 3 eyes (%5.4), postoperatively. After a median follow-up of 4 months postoperative best corrected visual acuity (BCVA) was 20/40 or better in 10 patients (18.2%). Lower rate of postoperative intraocular pressure higher than 25mmHg was present in eyes operated between 1 week and 1 month after cataract surgery (Chi-square test, p<0.02). Eyes with posterior chamber intraocular lenses (IOL) also had better corrected postoperative visual acuity than aphakic eyes. Retinal detachment was the major factor in the eyes with visual acuity of equal or less than 20/400 and accounted for 7 eyes (29.2 %)( 4 of 6 cases with RRD preoperatively had redetachment and 3 new cases with RRD postoperatively) .
Conclusion: The timing of vitrectomy was not found to be a factor affecting the final visual acuity (p>0.05, Chi-square test). Accompanying retinal pathologies are the most important factors that affect postoperative success. Keywords : Phacoemulsification, nucleus drop, retained lens fragments, pars plana vitrectomy
