OPTICAL COHERENCE TOMOGRAPHIC STUDY AFTER VITRECTOMY FOR DISLOCATED LENS FRAGMENTS AND/OR INTRAOCULAR LENS

Abstract

Background and Aim : Posterior dislocation of lens fragments is uncommon complication of phacoemulsification. However it is associated with sight threatening sequelae. These may include intraocular inflammation, secondary glaucoma, corneal edema, cystoid macular edema, and retinal detachment. Proper management is crucial to reduce the risk of these complications. Pars plana vitrectomy with intravitreal emulsification of dislocated lens fragments is indicated. Optimal timing for intervention is controversial. This study aimed to determine clinical outcomes and optical coherence tomography (OCT) changes of prompt, early and late pars plana vitrectomy with and without the use of intravitreal ultrasonic emulsification for dislocated lens fragments and/ or IOL. Methods : Thirty five eyes of 35 patients were recruited for the study. All cases underwent pars plana vitrectomy (PPV) for dislocated nuclear fragments after complicated phacoemulsification. A control group of 85 eyes with uneventful phacoemulsification were included. The clinical outcomes were visual acuity, intraocular pressure (IOP) and postoperative complications. OCT parameters including OCT-macula, OCT-Optic nerve head (ONH), and anterior segment OCT were measured at the 1 st , the 3 rd , the 6 th , the 9 th , and 12 th months postoperatively. Results : The results illustrated that eight eyes (22.8%) had CME detected by OCT at the 3rd months, while only 5 eyes (14.3%) at the 12 th months and only 4 eyes (11.4%) had chronic CME. Conclusion: Timing of PPV is an important factor affecting clinical and in dislocated nuclear fragments and IOL. The prompt PPV was associated with the best outcome followed by the early PPV. Cases in which, intravitreal ultrasound emulsification was indicated, had poorer prognostic outcome.