Retained Lens Fragments after Cataract Surgery: Outcomes of Same-Day versus Later Pars Plana Vitrectomy

Abstract

To compare visual acuity outcomes and adverse events in patients with retained lens fragments who underwent same-day versus later pars plana vitrectomy (PPV). Retrospective, interventional case series. Single-center study evaluating all patients with retained lens fragments that underwent PPV over a 22-year period (1990 through 2011). The study included 569 eyes of 568 patients with a mean age of 74.6 years and a median follow-up of 8 months (range, 1 week to 100 months). One hundred seventeen patients (22%) underwent same-day vitrectomy, 131 patients (23%) underwent PPV within 1 week, and 321 patients (57%) underwent PPV more than 1 week later. Median time to vitrectomy in the same week group was 5 days, compared with 22 days in the delayed group. At the last examination, 61%, 63%, and 56% of patients undergoing PPV on the same day, within 1 week, and more than 1 week later, respectively, achieved best-corrected visual acuity (BCVA) of 20/40 or better (P = .35), and 16%, 15%, and 21%, respectively, had BCVA of 20/200 or worse (P = .29). There were no differences between groups when assessing cystoid macular edema (P = .96), retinal detachment (P = .096), elevated intraocular pressure (P = .88), or suprachoroidal hemorrhage (P = .26). Patients undergoing same-day versus a later PPV (within 1 week or more than 1 week later) for retained lens fragments had similar visual acuity outcomes and complication rates. Although same-day surgery may be attractive logistically in many cases, our retrospective data suggest equivalent outcomes for surgical timing.