PURPOSE: To determine the visual outcome, prognostic factors, and effect of timing of surgical intervention in patients with retained lens fragments after phacoemulsification. METHODS: A retrospective review was carried out of the notes of 44 consecutive patients who suffered posterior dislocation of lens fragments during phacoemulsification, of whom 34 underwent vitrectomy. RESULTS: The presence of severe uveitis at presentation was a significant predictor of a final visual acuity of less than 6/60 (p = 0.002). A raised intraocular pressure at presentation (> 29 mmHg) significantly increased the risk of chronic glaucoma (p = 0.0279), but there was no association between glaucoma and delay in vitrectomy. Patients operated on within 1 week of cataract surgery obtained a better visual outcome (64.7%) of patients achieved 6/12 or better visual acuity) than those operated on later than 1 week (41% obtained 6/12), but this difference did not reach statistical significance. CONCLUSIONS: The trend towards a better visual outcome with early vitrectomy was not statistically significant. A large prospective trial is indicated to determine the optimum time for vitrectomy in these patients.
PURPOSE: To determine the visual outcome, prognostic factors, and effect of timing of surgical intervention in patients with retained lens fragments after phacoemulsification. METHODS: A retrospective review was carried out of the notes of 44 consecutive patients who suffered posterior dislocation of lens fragments during phacoemulsification, of whom 34 underwent vitrectomy. RESULTS: The presence of severe uveitis at presentation was a significant predictor of a final visual acuity of less than 6/60 (p = 0.002). A raised intraocular pressure at presentation (> 29 mmHg) significantly increased the risk of chronic glaucoma (p = 0.0279), but there was no association between glaucoma and delay in vitrectomy. Patients operated on within 1 week of cataract surgery obtained a better visual outcome (64.7%) of patients achieved 6/12 or better visual acuity) than those operated on later than 1 week (41% obtained 6/12), but this difference did not reach statistical significance. CONCLUSIONS: The trend towards a better visual outcome with early vitrectomy was not statistically significant. A large prospective trial is indicated to determine the optimum time for vitrectomy in these patients.
Authors: Weijie V Lin; Megan N Scott; Chosang Tendhar; Shazia F Ali; Zaina Al-Mohtaseb; Rizwan Shaikh; Christina Y Weng Journal: Clin Ophthalmol Date: 2020-03-26