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Small-gauge PPV removes dropped lens fragments, improves visual acuity
A hybrid small-gauge pars plana vitrectomy technique enabled successful removal of retained lens material after complicated cataract surgery, according to a study.
“Dropped lens fragments because of complicated cataract surgery can be managed well with 23-gauge pars plana vitrectomy: The majority of patients achieve a good visual acuity despite two surgeries at a rather low rate of retinal complications,” the study authors said.
The retrospective study included 42 eyes of 42 consecutive patients with a mean age of 74.6 years who underwent pars plana vitrectomy (PPV) for retained lens material at a single center. Mean follow-up was 35.2 months.
At the time of PPV, 23 eyes were pseudophakic and 19 eyes were aphakic. The mean interval between initial cataract surgery and PPV was 18.1 days.
Study results showed that final logMAR visual acuity was at least 0.3 in 35 eyes (83%), 0.2 or better in 32 eyes (76.2%) and 0 in 19 eyes (45.2%). Final visual acuity improved in 95.2% of eyes.
Patients with IOLs at the time of surgery and those who received secondary IOLs had similar postoperative visual acuity.
Maximal visual acuity was attained within 109.5 days for patients who had IOLs at the time of PPV and within 34 days for those who did not already have a lens implant.
Retinal detachment was identified in two eyes. One eye had a macula-sparing retinal detachment, and the other eye had a retinal detachment with involvement of the macula. Both eyes were treated successfully, the authors said.