Vitreoretinal surgery outcomes in patients with lens or lens fragments luxated into the vitreous cavity

Abstract

To evaluate the clinical characteristics of patients with lens or lens fragments luxated into the vitreous cavity and the visual and anatomical outcomes of pars plana vitrectomy (PPV) in these patients. This retrospective study reviewed the files of patients who had undergone PPV for lens or lens fragments luxation into the vitreous cavity at the Ophthalmology Department at Inonu University, Faculty of Medicine between January 2014-December 2018. Patient age, gender, preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior segment examination and posterior segment examination findings, preoperative and postoperative complications, and postoperative follow-up times were recorded. This study included 43 eyes of 43 total patients, of which 29 (67.4%) were male and 14 (32.6%) were female. Median patient age was 70 (36-89) years. Median preoperative BCVA was 1.7 (0.5-2) logMAR and median final BCVA was 0.8 (0-2) logMAR (p<0.001). Median preoperative IOP was 16 mmHg and median postoperative IOP was 14 mmHg (p=0.001). Postoperative visual acuity was better in 37 eyes, worse in 4 eyes, and unchanged in 2 eyes. Median postoperative BCVA was significantly better in patients who underwent PPV within three days, while their median preoperative and postoperative IOP were significantly lower (respectively p=0.019, p=0.027, p=0.027). Preoperatively, 13 eyes had shown high IOP, 9 had shown corneal edema, and 3 had shown retinal tears; while, postoperatively, 3 eyes developed retinal detachment and 3 eyes showed high IOP. Median postoperative follow-up time was 8 (3-57) months. PPV achieves successful anatomical and functional outcomes in patients with lens or lens fragments luxated into the vitreous cavity. Early surgical intervention within the first three days can result in better final visual acuity improvement and IOP control.