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Karen Chia, MD Chan Tat Keong, MD Peter Tseng, MD Doric Wong, MD

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1 Karen Chia, MD Chan Tat Keong, MD Peter Tseng, MD Doric Wong, MD
Visual outcome following immediate pars plana vitrectomy for posteriorly dislocated intravitreal lens fragments during phacoemulsification Karen Chia, MD Chan Tat Keong, MD Peter Tseng, MD Doric Wong, MD Singapore National Eye Centre

2 Purpose To evaluate visual outcomes and complications in patients with immediate pars plana vitrectomy for posteriorly dislocated intravitreal lens fragments during phacoemulsification

3 Methods Patients with posteriorly dislocated intravitreal lens fragments during phacoemulsification Underwent immediate pars plana vitrectomy by a vitreoretinal surgeon As part of the routine management strategy in a tertiary eye center. A retrospective review of all consecutive cases from to 2006 was performed. Data collected included demographics, best corrected visual acuity (BCVA) and complications including retinal detachment, raised intraocular pressure (IOP) and cystoid macular edema (CME).

4 Results Demographics 45 eyes of cases of phacoemulsification were included in the study Median age of patients: 69 years Median follow-up : 11 months after vitrectomy.

5 Best Corrected Visual Acuity
Median BCVA (logMar) Median BCVA (Snellen) Range (logMar) All patients 0.18 20/30 0.28 +/- 0.41 After excluding cases with pre-existing ocular problems 0.1 20/25 0.17 +/- 0.16

6 Patients with BCVA 20/40 or better

7 IOL implant

8 Complications of dropped nucleus
Complications occurred in 14 eyes. There were no cases of retinal detachment, 9 (20.5%) developed raised IOP and 4 (9.1%) developed CME.

9 Complications of dropped nucleus

10 Retina Complications

11 Factors associated with poor visual outcome
BCVA worse than 20/40 p value* Position of IOL implant Anterior Chamber 0.047 Presenting VA Worse than 20/60 0.042 Pre-existing ocular problems Present 0.457 Primary lens implant 0.364 Retinal Complications 0.586 Glaucoma Complications 0.36 * Fisher’s exact test

12 Conclusion The majority of cases of posteriorly dislocated intravitreal lens fragments had good visual outcome. Immediate pars plana vitrectomy has minimal sight-threatening complications and is a good management strategy to adopt in a tertiary setting.

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