Hybrid 20/23-gauge pars plana vitrectomy for retained lens fragments after cataract surgery

Abstract

Purpose: To evaluate the outcome and surgery-associated risks in patients undergoing 23-gauge pars plana vitrectomy (PPV) for retained lens fragments.

Methods: Retrospective analysis of 42 eyes of 42 consecutive patients at a tertiary teaching hospital in Sydney (Australia) during a period of 4 years. Evaluation of final visual acuity, complications, differences in patients receiving an intraocular lens at the primary cataract surgery, and differences in final visual acuity regarding the usage of a phacofragmatome and analysis of pars plana vitrectomy-related complications.

Results: The majority (83.3%) achieved a visual acuity of 0.3 (logarithm of the minimum angle of resolution) or better, and 19 eyes (45.2%) achieved a final visual acuity of 0 (logarithm of the minimum angle of resolution). Overall, 95.2% of the eyes had a better postoperative visual acuity compared with the preoperative visual acuity. There were no differences in proportions regarding the final visual acuity in patients who had an intraocular lens at the time of the pars plana vitrectomy and those who had a secondary lens implant. A retinal detachment after the lens fragment removal was observed in 2 eyes.

Conclusion: 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 2 surgeries at a rather low rate of retinal complications.