Retinal breaks in vitrectomy for retained lens fragments

• Published in: Retina (Philadelphia, Pa.) Vol. 32; no. 9; p. 1756
• Main Authors: Tan, H Stevie, Mura, Marco, Oberstein, Sarit Y Lesnik, Bijl, Heico M
• Format: Journal Article
• Language: English
• Published: United States 01.10.2012
• Subjects: Aged; Aged, 80 and over; Female; Follow-Up Studies; Humans; Incidence; Lens Subluxation - etiology; Lens Subluxation - surgery; Male; Middle Aged; Phacoemulsification - adverse effects; Postoperative Complications; Retinal Detachment - diagnosis; Retinal Detachment - etiology; Retinal Detachment - physiopathology; Retinal Perforations - diagnosis; Retinal Perforations - etiology; Retinal Perforations - physiopathology; Retrospective Studies; Time Factors; Treatment Outcome; Visual Acuity - physiology; Vitrectomy - adverse effects
• ISSN: 1539-2864
• DOI: 10.1097/IAE.0b013e3182576d46

To describe the incidence and outcome of retinal breaks in vitrectomy for retained lens fragments. This is a retrospective noncomparative interventional case series. Medical records of consecutive cases of vitrectomy for retained lens fragments over a period of 4 years were reviewed. Main outcome measures were incidence of breaks, visual acuity outcome, and occurrence of postoperative complications. We included 89 consecutive cases in 89 patients. The median interval between cataract surgery and vitrectomy was 2 days (range, 0-106 days). Visual acuity at last follow-up was ≥ 0.5 in 70% of cases. During surgery, retinal breaks were found in 29% of cases. Induction of a posterior vitreous detachment, the use of a fragmatome, or delay between cataract surgery and vitrectomy did not influence retinal break incidence. Postoperative retinal detachment occurred in only 2% of cases. Other complications were intraoperative choroidal hemorrhage in 1 case, postoperative macular pucker in 2, postoperative macular edema in 1, and glaucoma in 2 cases. We identified a high number of retinal breaks during vitrectomy for retained lens fragments. Prophylactic treatment of breaks and other areas of retinal traction seem to reduce the risk of postoperative retinal detachment.