Vitrectomy beneficial with retained lens fragments

An immediate vitrectomy should be considered in patients with retained intravitreal fragments of the crystalline lens after complicated cataract surgery. Eyes that underwent immediate vitrectomy had better visual acuity and a lower retinal detachment rate than eyes that underwent delayed vitrectomy.

Chicago-An immediate vitrectomy should be considered in patients with retained intravitreal fragments of the crystalline lens after complicated cataract surgery. Eyes that underwent immediate vitrectomy had better visual acuity (VA) than eyes that underwent delayed vitrectomy, according to Michael W. Stewart, MD, who reported his results at the American Society of Cataract and Refractive Surgery annual meeting.

"The first reports on retained crystalline lens fragments emerged in the literature in the early 1990s and found that from 50% to 67% of patients achieved subsequent visual acuities of 20/40 or better," said Dr. Stewart, who is affiliated with the Department of Ophthalmology, Mayo Clinic, Jacksonville, FL. "Later reports, early in the next decade, showed comparable visual acuity results, but these studies also emphasized the importance of the development of retinal detachments and glaucoma as adverse visual outcomes.

"Some authors proposed that immediate vitrectomy performed in these patients results in improved visual acuity. However, other large studies contradicted that thesis," Dr. Stewart said. "Other authors thought that immediate vitrectomy minimized the risk of the development of secondary glaucoma."

He summarized the experience with patients with retained lens fragments at the Mayo Clinic. An 8-year retrospective analysis of 6,676 cataract surgeries performed at the Mayo Clinic indicated that 0.48% of cases had retained crystalline lens fragments, Dr. Stewart said.

Read the full story in the August 1 issue of Ophthalmology Times.