Pars Plana Vitrectomy for Retained Lens Fragments After Cataract Surgery: Outcomes Based on Timing of Surgery

Abstract

Purpose

To evaluate the outcomes and complications in patients with retained lens fragments (RLF) after cataract surgery, comparing those who received pars plana vitrectomy (PPV) on the same day, within 1 week, or later than 1 week after cataract surgery.

Patients and Methods

Retrospective case series of all patients who underwent PPV for RLF at Bascom Palmer Eye Institute between January 1, 2012 and September 30, 2020. Individuals with less than 3 months of follow-up, chronic uveitis, congenital cataract, previtrectomy retinal detachment (RD), and severe trauma were excluded. All analyses for categorical and binary variables used chi-squared tests. Analyses for continuous variables were performed using multivariate analyses of covariance, adjusting for differences in baseline visual acuity before cataract surgery.

Results

The study included 246 eyes of 246 patients. The timing distribution included the following: 140 (57%) eyes underwent same-day PPV, 33 (13%) eyes underwent same-week PPV, and 73 (30%) eyes underwent PPV after 1 week (up to 90 days). When all eyes were included in analysis, there were no statistically significant differences in mean best-corrected visual acuity (BCVA) between groups at last follow-up examination (P = 0.07). When only eyes without known pre-existing ocular disease (N = 157) were included in analysis, there were no differences in mean BCVA between groups at all postoperative timepoints (P > 0.05). The rate of RD did not differ between groups when eyes with and without pre-existing ocular disease were analyzed (P > 0.05).

Conclusion

In the current study, there were no statistically significant differences in postoperative BCVA or rates of RD at last follow-up examination in eyes undergoing PPV for RLF on the same day, within 1 week, or later than 1 week after cataract surgery.

Keywords:

• retained lens fragments
• pars plana vitrectomy
• cataract surgery
• retinal detachment

Informed Consent

Requirement of informed consent was waived by the institutional review board due to the retrospective nature of the study.

Disclosure

Nicolas A Yannuzzi is a consultant/advisor for EyePoint, Genentech, Regeneron, REGENXBIO, and Gyroscope. Jayanth Sridhar is a consultant for Genentech, Regeneron, Alcon, Apellis, Ocuterra, DORC, and Allergan. Audina M Berrocal is a consultant for Alcon, Allergan, Bayer, DORC, Phoenix Clinical, Visunex Medical System, Novartis, and Zeiss. Thomas A Albini is a consultant for Allergan and EyePoint. Jorge A Fortun is a consultant for DORC and Carl Zeiss and receives financial support from Aldreya. The authors report no other conflicts of interest in this work.

Additional information

Funding

NIH Center Core Grant P30EY014801 (Bethesda, MD), Research to Prevent Blindness-Unrestricted Grant to BPEI (GR004596; New York, NY). The sponsors had no role in the design or execution of the study.