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Retained nuclear fragments after pars plana vitrectomy linked to poor visual outcomes
Eur J Ophthalmol. 2011;21(6):741-747.
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Worse visual outcomes were associated with the presence of retained nuclear lens fragments than cortex or epinucleus fragments identified after pars plana vitrectomy following phacoemulsification, a study found.
"However, it is possible that retaining nuclear fragments represents more complicated and traumatic cataract surgery, more traumatic vitrectomy, and more mechanical and inflammatory damage to the retina," the study authors said.
The retrospective study included 63 eyes of 63 patients. Mean patient age was 73.6 years.
Thirty-two eyes underwent vitrectomy; 16 eyes had retained nuclear lens fragments and 16 eyes had retained epinucleus or cortex fragments. Vitrectomy was not performed in 23 eyes; data were missing for eight eyes.
IOLs were implanted in 27 eyes, and 36 eyes remained aphakic. Implants included 16 posterior chamber IOLs and 11 anterior chamber IOLs. Mean follow-up was 14.5 months.
Forty-two eyes (67%) had retained nuclear fragments and 21 eyes (33%) had retained non-nuclear fragments.
Results showed that 38.8% of eyes with nuclear fragments and 77.7% of eyes with non-nuclear fragments attained final visual acuity of 20/40 or better. The between-group difference was statistically significant (P = .007).
Other factors such as nuclear fragment size did not correlate with final visual acuity. The most common complications were cystoid macular edema, glaucoma, retinal detachment and pseudophakic bullous keratopathy, the authors said.