A 3-Year Review of the Outcome of Pars Plana Vitrectomy for Dropped Lens Fragments after Cataract Surgery in a Tertiary Eye Hospital in Dhaka, Bangladesh

Abstract

BACKGROUND: Dropped lens fragments into the vitreous areuncommon, but potentially sight threatening complications ofcataract surgery. The recommended approach for removal ofdropped lens matter is pars plana vitrectomy with or withoutultrasonic emulsification with the fragmatome. This study aimed todetermine the visual outcome following pars plana vitrectomy fordropped lens fragments complicating cataract surgery at 6 weeks, 3months and 6 months.METHODS: This study is a retrospective review of patients whohad PPV as treatment for dropped lens fragments complicatingcataract surgery at Ispahani Islamia Eye hospital and Institute.The case notes of all patients who had PPV for dropped nucleusfrom January 2013 to December 2015 were reviewed. Informationretrieved included the bio-data of the patients, clinical featuressuch as visual acuity, intraocular pressure, cornea clarity, presenceof anterior chamber activity, Lens status and fundus findings atpresentation, 6 weeks, 3 months and 6 months post surgery. Detailsof intra ocular procedure (Cryotherapy, Endo laser, Silicon oil orgas tamponade) in addition to PPV were noted.RESULT: Thirty- two cases were reviewed within the 36-monthtime period. There were 8(25%) females and 24(75%) males. Maleto female ratio was 1:3. The best corrected visual acuity of patientsat presentation was better than or equal to 6/60 in 56.3% of thepatients. Dropped nucleus occurred during phacoemulsificationcataract surgery in the majority (59.6%) of the patients. The bestcorrected visual acuity was 6/18 or better in 10(31.3%) eyes at 6months post-surgery. Worsening of visual acuity to light perceptionoccurred in 3(9.4%) eyes at 6 months, and 3 eyes (9.4%) developedphthisis bulbi.CONCLUSION: Modest improvement in visual acuity can beachieved after dropped nucleus complicating cataract surgery byPars plana vitrectomy and removal of dislocated lens fragment.