Journal List > J Korean Ophthalmol Soc > v.53(1) > 1009356

Choi, Choi, Lee, and Rhee: Surgical Outcomes for Lens Fragments Dropped into the Vitreous Cavity during Cataract Surgery

Abstract

Purpose

To assess the clinical features and outcomes of patients referred for management of dropped lens fragments during cataract surgery.

Methods

The medical records of 22 eyes from 22 patients who were referred to our hospital to undergo pars plana vitrectomy (PPV) for management of dropped lens fragments after phacoemulsification surgery at private clinics were reviewed. Data including patient demographics, preoperative and postoperative visual acuity, factors associated with dropped lens fragment, and postoperative complications were recorded. The factors were compared between 2 patient groups: postoperative Snellen acuity of 0.5 or better and acuity less than 0.5. The statistical significances of differences in factors between the 2 groups were calculated.

Results

The mean interval between cataract surgery and PPV was 2.6 ± 3.7 days. At the final examination, the mean postoperative acuity was 0.57 ± 0.20, and 16 eyes (72.7%) had a visual outcome of 0.5 or better. After excluding 7 eyes with other pre-existing ocular co-morbidities, 14 eyes (93.0%) achieved a final visual acuity of 0.5 or better. Multivariate analysis showed that the predictor for visual outcomes of 0.5 or better was absence of preoperative eye disease (p = 0.007). Complications after PPV included 2 (9.0%) cases of cystoid macular edema and 1 (4.5%) case of retinal detachment.

Conclusions

Prompt referral and surgical management within 1 week for dropped lens fragments during cataract surgery may achieve a better visual outcome in cases with no pre-existing eye disease.

Figures and Tables

Table 1
Studies reporting final visual acuity, the incidence of glaucoma, retinal detachment, and cystoid macular edema for patients who underwent pars plana vitrectomy for retained lens fragments
jkos-53-68-i001

VA = visual acuity; RD = retinal detachment; CME = cystoid macular edema; NR = not reported.

Table 2
Clinical features of 22 eyes that underwent immediate pars plana vitrectomy for dropped lens fragments following cataract surgery
jkos-53-68-i002

VA = visual acuity; IOP = intraocular pressure; IOL = intraocular lens; AMD = age-related macular degeneration; NPDR = nonproliferative diabetic retinopathy; CF = counting fingers; HM = hand movements; RH = retinal hemorrhage; ERM = epiretinal membrane.

*1 = ≤25%; 2 = 25-50%; 3 = 50-75%; 4 = ≥75%.

Table 3
Operative procedure and postoperative complication for eyes with dropped lens fragments
jkos-53-68-i003

PPV = pars plan vitrectomy; IOL = intraocular lens; VA = visual acuity; ELP = endolaser photocoagulation; CTR = capsular tension ring; PFCL = perfluorocarbon liquids; scl-fix = scleral fixation; CME = cystoid macular edema; RD = retinal detachment.

Table 4
Patients who underwent PPV for dropped lens fragments: previtrectomy factors associated with good final vision (≥ 0.5 Snellen VA) by univariate analysis
jkos-53-68-i004

VA = visual acuity; PPV = pars plana vitrectomy; CCC = continuous circular capsulorhexis; CF = counting fingers; IOP = intraocular pressure; IOL = intraocular lens.

*Statistical significance was calculated by Chi-square test; p<0.05.

Table 5
Results of multivariate analysis of factors which associated with good final vision (≥ 0.5 Snellen VA) by univariate analysis
jkos-53-68-i005

VA = visual acuity.

*Statistical significance was calculated by multiple logistic regression analysis; p<0.05.

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