Pars plana vitrectomy for dislocated crystalline/artificial intraocular lens: Factors predicting the visual outcome

Abstract

Aims: This study aims to study the factors predicting the visual outcome of pars plana vitrectomy (PPV) done for dislocated crystalline or artificial intraocular lens (IOL). Settings and Design: This was a retrospective observational study. Subjects and Methods: The records of patients who underwent PPV with lens retrieval and IOL exchange or repositioning for traumatic or iatrogenic dislocation of crystalline or artificial IOL were reviewed. Pre- and post-operative visual acuity and complications were recorded. Six-month patient follow-up data were reviewed. Statistical Analysis Used: Chi-square test. Results: Final best-corrected visual acuity (BCVA) 6/60 or better was found in the majority of patients who underwent PPV within 1 year of dislocation, but for patients who were delayed for over a year, the final BCVA was <6/60 (P = 0.001). Significant correlations were found between delayed PPV and postoperative retinal detachment (RD) (P = 0.001); between PPV for dislocated nuclear fragment(s) due to complicated cataract surgery and preoperative uveitis (P = 0.007) as well as postoperative cystoid macular edema (CME) (P = 0.001); between preoperative corneal edema and postoperative corneal decompensation (P = 0.03). Finally, the final BCVA <6/60 had significant correlations with preoperative corneal edema (P = 0.001) and uveitis (P = 0.039) and with postoperative corneal decompensation (P = 0.013), CME (P = 0.001), and RD (P = 0.001). Conclusions: In cases of dislocated lens, factors such as delayed intervention, dislocated nuclear fragment(s), preoperative uveitis, and corneal edema were related to increased postoperative sight-threatening complications resulting in poorer visual outcome.