advertisement
Abstract #47857 Published in IGR 13-4
Retained lens fragments: Nucleus fragments are associated with worse prognosis than cortex or epinucleus fragments
Moisseiev E; Kinori M; Glovinsky Y; Loewenstein A; Moisseiev J; Barak AEuropean Journal of Ophthalmology 2011; 21: 741-747
Purpose. To identify factors that determined the outcome of eyes that underwent pars plana vitrectomy for retained lens fragments after phacoemulsification. Methods. A retrospective review of the records of 63 eyes that underwent vitrectomy for retained lens fragments after phacoemulsification. Fragments were defined as nuclear if they contained any nucleus component or non-nuclear if they contained only cortex and epinucleus. Nuclear fragments were further divided into large (at least 1/3 the size of the nucleus) or small. Results. A total of 67% of eyes had retained nuclear fragments and 33% had non-nuclear fragments. Of the eyes with nuclear fragments, 64% had large fragments and 36% had small fragments. Statistical analysis revealed that the lens fragment type was the major determinant of the final visual acuity (VA). Only 38.8% (14/36) of the eyes with nuclear fragments achieved final VA of 20/40 or better, compared with 77.7% (14/18) of eyes with non-nuclear fragments (p=0.007). All other parameters, including size of the nuclear fragment, were not correlated with final VA. The major complications encountered in this series were retinal detachment (12.6%), pseudophakic bullous keratopathy (6.3%), cystoid macular edema (15.8%), and glaucoma (15.8%). Conclusions. The major finding of our study is that posterior dislocation of nuclear lens fragments is associated with worse visual outcome than that of non-nuclear fragments. This may be related to a more complicated course of the cataract surgery, direct mechanical damage to the retina, a stronger inflammatory response, or a more traumatic vitrectomy procedure. (copyright) 2011 Wichtig Editore - ISSN 1120-6721.
E. Moisseiev. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 6 Weitzman St., Tel Aviv 64239, Israel. Email: elad_moi@netvision.net.il
Classification:
9.4.11.5 Glaucomas associated with vitreoretinal surgery (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.11 Glaucomas following intraocular surgery)
