Vitreoretinal surgery outcomes in patients with lens or lens fragments luxated into the vitreous cavity

To evaluate the clinical characteristics of patients with lens or lens fragments luxated into the vitreous cavity and the visual and anatomical outcomes of pars plana vitrectomy (PPV) in these patients. This retrospective study reviewed the files of patients who had undergone PPV for lens or lens fragments luxation into the vitreous cavity at the Ophthalmology Department at Inonu University, Faculty of Medicine between January 2014-December 2018. Patient age, gender, preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior segment examination and posterior segment examination findings, preoperative and postoperative complications, and postoperative follow-up times were recorded. This study included 43 eyes of 43 total patients, of which 29 (67.4%) were male and 14 (32.6%) were female. Median patient age was 70 (36-89) years. Median preoperative BCVA was 1.7 (0.5-2) logMAR and median final BCVA was 0.8 (0-2) logMAR (p

PDF

___

Pande N, Dobbs TR. Incidence of lens matter dislocation during phacoemulsification. J Cataract Refract Surg. 1996; 22:737‑742.
Steinberg DA, Leslie CL. Traumatic dislocation of the crystalline lens. J Trauma. 2005;58:213-4.
Çıtırık M, Özçelik Soba D, Yılmazbaş P. Vitreusa düşen lens veya lens parçası olgularında vitreoretinal cerrahi. MN Oftalmoloji. 2015;22:103-6
Marr JE, Hallwell-Ewen J, Fisher B, et al. Associations of high myopia in childhood. Eye. 2001;15:70-
Cionni RJ, Osher RH, Marques DM. Modified capsular tension ring for patients with congenital loss of zonular support. J Cataract Refract Surg. 2003;29:1668-73.
Kageyama T, Ayaki M, Ogasawara M, et al. Results of vitrectomy performed at the time of phacoemulsification complicated by in¬travitreal lens fragments. Br J Ophthalmol. 2001;85:1038-40.
Yeo LM, Charteris DG, Bunce C, et al. Retained intravitreal lens fragments after phacoemulsification: a clinicopathological correlation. Br J Ophthalmol. 1999;83:1135-8.
Rossetti A, Doro D. Retained intravitreal lens fragments after phacoemulsification: complications and visual outcome in vitrectomized and nonvitrectomized eyes. J Cataract Refract Surg. 2002;28:310-5.
Rofagha S, Bhisitkul RB. Management of retained lens fragments in complicated cataract surgery. Curr Opin Ophthalmol 2011;2:137‑40.
Vanner EA, Stewart MW. Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: a systematic review and meta-analysis. Am J Ophthalmol. 2011;152:345-57.
Ross WH. Management of dislocated lens fragments after phacoemulsification surgery. Can J Ophthalmol. 1996;31:234-5.
Verma L, Gogoi M, Tewari HK, et al. Comparative study of vit¬rectomy for dropped nucleus with and without the use of perfluo¬rocarbon liquid. Clinical, electrophysiological and visual field out¬comes. Acta Ophthalmol Scand. 2001;79:354-8.
Monshizadeh R, Samiy N, Haimovici R.: Management of retained intravitreal lens fragments after cataract surgery. Surv Ophthal¬mol. 1999;43:397-404.
Toklu Y, Yorgun MA, Çakmak HB, et al. Factors affecting visual acuity among patients with pars plana vitrectomy due to nucleus dislocation during phacoemulsification surgery. Ret-Vit. 2011;19:262-6.
Öner A, Kılıç R, Polat OA, et al. Pars plana vitrectomy for dislocated intraocular lenses and nucleuses during cataract surgery and related to trauma. Cumhuriyet Med J. 2013;35:345-9.
Stefaniotou M, Aspiotis M, Pappa C, et al. Timing of dislocated nuclear fragment management after cataract surgery. J Cataract Refract Surg. 2003;29:1985-8.
Vanner EA, Stewart MW, Liesegang TJ, et al. A retrospective cohort study of clinical outcomes for intravitreal crystalline retained lens fragments after age‑related cataract surgery: A comparison of same‑day versus delayed vitrectomy. Clin Ophthalmol. 2012;6:1135‑48.
Rowson NJ, Bacon AS, Rosen PH. Perfluorocarbon heavy liquids in the management of posterior dislocation of the lens nucleus during phacoemulsification. Br J Ophthalmol. 1992;76:169-70.
Lashgari A, Kabiri M, Ramezani A, et al. Visual and Anatomical Outcomes of Pars Plana Vitrectomy for Dropped Nucleus after Phacoemulsification. J Ophthalmic Vis Res. 2018;13:253‑9.
Salam GA, Greene JM, Deramo VA, et al. Retinal tears and retinal detachment as factors affecting visual outcome after cataract extraction complicated by posteriorly dislocated lens material. Retina. 2005;25:570‑5.
Scupola A, Abed E, Sammarco MG, et al. Gauge pars plana vitrectomy for retained lens fragments in complicated cataract surgery. Ophthalmologica. 2015;234:101‑8.
Baker PS, Spirn MJ, Chiang A, et al. 23‑Gauge transconjunctival pars plana vitrectomy for removal of retained lens fragments. Am J Ophthalmol. 2011;152:624‑7.
Ho Ly, Doft BH, Wang L, Bunker CH. Clinical predictors and outcomes of pars plana vitrectomy for retained lens material after cataract extraction. Am J Ophthalmol. 2009;147:587‑94.
Ho SF, Zaman A. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments after phacoemulsification. J Cataract Refract Surg. 2007;33:2106‑10.
Merani R, Hunyor AP, Playfair TJ, et al. Pars plana vitrectomy for the management of retained lens material after cataract surgery. Am J Ophthalmol. 2007;144:364‑70.
Watts P, Hunter J, Bunce C. Vitrectomy and lensectomy in the management of posterior dislocation of lens fragments. J Cataract Refract Surg. 2000;26:832‑7.
Scott IU, Flynn HW Jr., Smiddy WE, et al. Clinical features and outcomes of pars plana vitrectomy in patients with retained lens fragments. Ophthalmology. 2003;110:1567-72.
Salehi A, Razmju H, Beni AN, et al. Visual outcome of early and late pars plana vitrectomy in patients with dropped nucleus during phacoemulsification. J Res Med Sci. 2011;16:1422-9.
Bansal AS, Hsu J, Garg SJ, et al. Optic neuropathy after vitrectomy for retinal detachment: Clinical features and analysis of risk factors. Ophthalmology. 2012;119:2364‑70.
Tajunisah I, Reddy SC. Dropped nucleus following phacoemulsification cataract surgery. Med J Malaysia. 2007;62:364‑7.
Moore JK, Scott IU, Flynn HW Jr, et al. Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. Ophthalmology. 2003;110:709‑14.
Ünver YB, Acar N, Kapran Z, et al. Vitreoretinal surgery in traumatized cases with traumatic crystalline lens dislocation/subluxation. Ret-Vit. 2005;13:205-9.
Akıncı A, Batman C, Özalp S, et al. Outcomes of Pars Plana Vitrectomy and Pars Plana Lensectomy in Cases with Traumatic Lens Subluxation and Cataract. Turkiye Klinikleri J Ophthalmol. 2008;17:233-7.
Chuang LH, Lai CC. Secondary intraocular lens implantation of traumatic cataract in open-globe injury. Can J Ophthalmol. 2005;40:454-9.