Immediate pars plana vitrectomy improves outcome in retained intravitreal lens fragments after phacoemulsification

Purpose: To investigate the clinical features, visual acuity outcomes and the most appropriate intervention time in patients with retained lens fragments managed by pars plana vitrectomy. Methods:This was a retrospective review of the records of 78 patients who underwent pars plana vitrectomy for retained lens fragments at the Tri-Service General Hospital from January 1, 2000, to December 31, 2006. Results:The mean age of the patients was 70 years (range, 24-92 years). There were 40 men (51%) and 38 women (49%). The mean follow-up period after surgery was 13.8 months. Forty-five patients (58%) had vitrectomy within I day of phacoemulsification (group A), 22 (28%) within 1 week (group 13) and 11 (14%) after more than 1 week (group Q. No patients in group A developed complications, and 76% achieved a final visual acuity of 6/12 or better. In group 13, all patients had elevated intraocular pressure, and 45% achieved a final visual acuity of 6/12 or better. In group C, all patients presented with corneal edema, moderate or severe uveitis, and elevated intraocular pressure. Of these patients, 27% had cystoid macular edema, 36% developed retinal detachment, and 27% had a final visual acuity of 6/12 or better. Conclusion: Pars plana vitrectomy performed immediately after cataract surgery for retained lens fragments is a viable option and may achieve a better visual outcome, with reduced risk of secondary glaucoma, retinal detachment or cystoid macular edema. Copyright (c) 2008 S. Karger AG, Basel.