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Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments.
Ophthalmology 2003; 110(4):709-13; discussion 713-4O

Abstract

PURPOSE

To investigate the incidence and outcomes of retinal detachment (RD) associated with retained lens fragments removed by pars plana vitrectomy (PPV).

DESIGN

Retrospective, noncomparative, interventional consecutive case series.

PARTICIPANTS

All patients who underwent PPV for retained lens material after cataract surgery at Bascom Palmer Eye Institute between January 1, 1990, and December 31, 2001.

METHODS

Demographic and clinical data were extracted from patients' medical records.

MAIN OUTCOME MEASURES

Incidence of retinal detachment, reattachment rate, and visual acuity outcome.

RESULTS

RD occurred in 44 of 343 (12.8%) patients, including 25 (7.3%) before or during PPV and 19 (5.5%) after PPV. The RD was macula-on in 22 of 44 (50%) patients and macula-off in 22 of 44 (50%) patients. The RD was associated with a giant retinal tear in 7 of 44 (15.9%) patients, limited suprachoroidal hemorrhage in 3 of 44 (6.8%) patients, and endophthalmitis in 4 of 44 (9.1%) patients. Retinal reattachment was achieved in 40 of 44 (90.9%) patients; 14 of 44 (31.8%) patients underwent one or more additional procedures for recurrent detachment. Final visual acuity in the patients in this series was >/=20/40 in 8 of 44 (18%), 20/50 to 20/100 in 13 of 44 (30%), 20/200 to 5/200 in 13 of 44 (30%), and <5/200 in 10 of 44 (23%). In the 36 patients with vision less than 20/40, the primary causes of decreased vision were attributed to prior history of RD in 8 of 36 (22.2%), corneal edema in 7 of 36 (19.4%), cystoid macular edema in 5 of 36 (13.9%), persistent retinal detachment in 4/36 (11.1%), preexisting primary open-angle glaucoma in 4 of 36 (11.1%), age-related macular degeneration in 3 of 36 (8.3%), epiretinal membrane in 2 of 36 (5.5%), macular hole in 1 of 36 (2.7%), optic atrophy in 1 of 36 (2.7%), and irregular astigmatism in 1 of 36 (2.7%) patients.

CONCLUSIONS

RD is a frequent complication in eyes undergoing PPV for removal of retained lens fragments. Despite favorable retinal reattachment rates, visual acuity outcomes are often poor in these eyes and are associated with other comorbidities such as corneal edema and cystoid macular edema. Poor initial visual acuity and the presence of a retinal tear at the time of PPV were associated with a higher rate of RD after PPV.

Authors+Show Affiliations

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12689890

Citation

Moore, Jeffrey K., et al. "Retinal Detachment in Eyes Undergoing Pars Plana Vitrectomy for Removal of Retained Lens Fragments." Ophthalmology, vol. 110, no. 4, 2003, pp. 709-13; discussion 713-4.
Moore JK, Scott IU, Flynn HW, et al. Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. Ophthalmology. 2003;110(4):709-13; discussion 713-4.
Moore, J. K., Scott, I. U., Flynn, H. W., Smiddy, W. E., Murray, T. G., Kim, J. E., ... Jorge, R. (2003). Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. Ophthalmology, 110(4), pp. 709-13; discussion 713-4.
Moore JK, et al. Retinal Detachment in Eyes Undergoing Pars Plana Vitrectomy for Removal of Retained Lens Fragments. Ophthalmology. 2003;110(4):709-13; discussion 713-4. PubMed PMID: 12689890.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retinal detachment in eyes undergoing pars plana vitrectomy for removal of retained lens fragments. AU - Moore,Jeffrey K, AU - Scott,Ingrid U, AU - Flynn,Harry W,Jr AU - Smiddy,William E, AU - Murray,Timothy G, AU - Kim,Judy E, AU - Vilar,Nancy F, AU - Pereira,Mauricio B, AU - Jorge,Rodrigo, PY - 2003/4/12/pubmed PY - 2003/5/8/medline PY - 2003/4/12/entrez SP - 709-13; discussion 713-4 JF - Ophthalmology JO - Ophthalmology VL - 110 IS - 4 N2 - PURPOSE: To investigate the incidence and outcomes of retinal detachment (RD) associated with retained lens fragments removed by pars plana vitrectomy (PPV). DESIGN: Retrospective, noncomparative, interventional consecutive case series. PARTICIPANTS: All patients who underwent PPV for retained lens material after cataract surgery at Bascom Palmer Eye Institute between January 1, 1990, and December 31, 2001. METHODS: Demographic and clinical data were extracted from patients' medical records. MAIN OUTCOME MEASURES: Incidence of retinal detachment, reattachment rate, and visual acuity outcome. RESULTS: RD occurred in 44 of 343 (12.8%) patients, including 25 (7.3%) before or during PPV and 19 (5.5%) after PPV. The RD was macula-on in 22 of 44 (50%) patients and macula-off in 22 of 44 (50%) patients. The RD was associated with a giant retinal tear in 7 of 44 (15.9%) patients, limited suprachoroidal hemorrhage in 3 of 44 (6.8%) patients, and endophthalmitis in 4 of 44 (9.1%) patients. Retinal reattachment was achieved in 40 of 44 (90.9%) patients; 14 of 44 (31.8%) patients underwent one or more additional procedures for recurrent detachment. Final visual acuity in the patients in this series was >/=20/40 in 8 of 44 (18%), 20/50 to 20/100 in 13 of 44 (30%), 20/200 to 5/200 in 13 of 44 (30%), and <5/200 in 10 of 44 (23%). In the 36 patients with vision less than 20/40, the primary causes of decreased vision were attributed to prior history of RD in 8 of 36 (22.2%), corneal edema in 7 of 36 (19.4%), cystoid macular edema in 5 of 36 (13.9%), persistent retinal detachment in 4/36 (11.1%), preexisting primary open-angle glaucoma in 4 of 36 (11.1%), age-related macular degeneration in 3 of 36 (8.3%), epiretinal membrane in 2 of 36 (5.5%), macular hole in 1 of 36 (2.7%), optic atrophy in 1 of 36 (2.7%), and irregular astigmatism in 1 of 36 (2.7%) patients. CONCLUSIONS: RD is a frequent complication in eyes undergoing PPV for removal of retained lens fragments. Despite favorable retinal reattachment rates, visual acuity outcomes are often poor in these eyes and are associated with other comorbidities such as corneal edema and cystoid macular edema. Poor initial visual acuity and the presence of a retinal tear at the time of PPV were associated with a higher rate of RD after PPV. SN - 0161-6420 UR - https://www.unboundmedicine.com/medline/citation/12689890/Retinal_detachment_in_eyes_undergoing_pars_plana_vitrectomy_for_removal_of_retained_lens_fragments_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(03)00020-4 DB - PRIME DP - Unbound Medicine ER -