Same-day versus delayed vitrectomy with lensectomy for the management of retained lens fragments

Marcus H. Colyer*, Daniel M. Berinstein, Noureen J. Khan, Eric D. Weichel, Michael M. Lai, William F. Deegan, Reshma C. Katira, William B. Phillips, Reginald J. Sanders, Richard A. Garfinkel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Purpose: To evaluate whether performing same-day pars plana vitrectomy versus delayed pars plana vitrectomy affects visual outcomes and ocular morbidity of patients with retained lens fragments after a complicated cataract surgery. Methods: Retrospective, comparative case series of 172 eyes of 171 patients with retained lens fragments undergoing 3-port pars plana vitrectomy using 20-, 23-, or 25-gauge instrumentation between 2005 and 2008. Outcome measures included best-corrected visual acuity at 6 months, final best-corrected visual acuity, and postoperative complications such as cystoid macular edema, intraocular pressure elevation, retinal detachment, vitreous hemorrhage, choroidal hemorrhage, and endophthalmitis. Results: The median age was 75 ± 0.8 years. The mean time to vitrectomy for the delayed group was 15 ± 2 days. The preoperative logarithm of the minimum angle of resolution best-corrected visual acuity for immediate vitrectomy was 0.73 ± 0.09 versus 0.72 ± 0.06 for delayed vitrectomy. Six-month logarithm of the minimum angle of resolution acuity was 0.44 ± 0.09 for same-day vitrectomy compared with 0.44 ± 0.05 for delayed vitrectomy (P = 0.97, 2-tailed t-test). Of 59 eyes undergoing immediate vitrectomy, 17 (29%) experienced postoperative complications, while 38 of 113 eyes (34%), experienced complications if undergoing delayed vitrectomy (Fisher exact test, P = 0.61). Overall, the most common complication was cystoid macular edema occurring in 25 of 172 eyes (15%). Conclusion: The outcomes of same-day pars plana vitrectomy appear to be similar to non-same-day pars plana vitrectomy. The risks and benefits related to the timing of vitrectomy after a complicated cataract surgery should be carefully discussed with each patient. Further investigation is warranted to establish an optimal time for surgical planning.

Original languageEnglish
Pages (from-to)1534-1540
Number of pages7
JournalRetina
Volume31
Issue number8
DOIs
StatePublished - Sep 2011
Externally publishedYes

Keywords

  • 20-gauge vitrectomy
  • 23-gauge vitrectomy
  • 25-gauge vitrectomy
  • cataract
  • cataract surgery complications
  • pars plana vitrectomy
  • pseudophakic
  • retained lens fragments
  • same-day vitrectomy

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