Dropped Lens Fragments Retrieval Using Endoscopy-Assisted Pars Plana Vitrectomy in Patients With Corneal Opacity

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-03-11 DOI:10.1016/j.ajo.2025.03.012

Amanda K. Hertel, Martin A. Mainster, Mary Champion, Radwan S. Ajlan

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Abstract

PURPOSE

To characterize the surgical outcomes of endoscopy-assisted pars plana vitrectomy (E-PPV) in dropped lens fragments retrieval in patients with corneal opacity.

BACKGROUND

Corneal opacity may delay dropped lens fragment retrieval because of limited fundus view. E-PPV permits posterior segment visualization through corneal opacity. There are limited data on E-PPV use for dropped lens fragments retrieval in the literature.

DESIGN

Retrospective cohort study.

METHODS

A retrospective chart review was performed of dropped lens fragments retrieval procedures done between 2013 and 2023 at a tertiary referral center. Data were collected on the surgical approach, visual acuity (VA), and intraocular pressure (IOP), as well as complication rates including retinal detachment (RD), cystoid macular edema (CME), and epiretinal membrane formation (ERM). Statistical analysis was performed using t tests and chi-square tests. Statistical significance was defined as a P value of .05.

RESULTS

There were 74 patients who met the inclusion criteria (31 patients had E-PPV, and 43 patients had standard pars plana vitrectomy [S-PPV]). Groups were balanced in age and gender. Postoperative CME rate was 25.8% after E-PPV and 25.58% after S-PPV (P = .95). Postoperative RD rate was 0% after E-PPV and 7% S-PPV (P = .13). After 1 year, there was no difference in postoperative VA, IOP, and rates of RD, CME, or ERM between groups. Interval time to dropped lens retrieval did not change the final outcome in either group.

CONCLUSIONS

This study showed that performing E-PPV to extract dropped lens fragments through corneal opacity had similar final outcomes compared with S-PPV, regardless of the interval time to surgery after the dropped lens fragments. Removing dropped lens fragments using E-PPV before cornea opacity clearance provided outcomes similar to those of delayed cases. Further studies are needed on the psychological benefit in patients undergoing dropped lens removal sooner than others.

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内窥镜辅助玻璃体切割术治疗角膜混浊患者的晶状体碎片回收。

目的：探讨内窥镜辅助玻璃体切除（E-PPV）治疗角膜混浊患者晶状体碎片脱落的手术效果。背景：由于眼底视野受限，角膜混浊可能会延迟掉落晶状体碎片的回收。E-PPV可透过角膜混浊层显示后段。文献中关于E-PPV用于晶状体碎片回收的数据有限。设计：回顾性队列研究。方法：回顾性回顾2013年至2023年在三级转诊中心进行的掉落晶状体碎片回收手术的图表。收集手术入路、视力（VA）和眼压（IOP）以及并发症发生率，包括视网膜脱离（RD）、囊样黄斑水肿（CME）和视网膜前膜形成（ERM）。采用t检验和卡方检验进行统计学分析。统计学意义定义为p值为0.05。结果：74例患者符合纳入标准（E-PPV 31例，S-PPV标准43例）。各组在年龄和性别上是平衡的。E-PPV术后CME率为25.8%，S-PPV术后CME率为25.58% （p值：0.95）。E-PPV术后RD率为0%，S-PPV术后RD率为7% （p值：0.13）。一年后，两组之间的术后VA、IOP和RD、CME或ERM发生率无差异。摘除晶状体的间隔时间没有改变两组的最终结果。结论：本研究表明，无论晶状体碎片脱落后的手术间隔时间如何，通过角膜混浊进行E-PPV提取晶状体碎片的最终结果与S-PPV相似。在清除角膜混浊之前使用E-PPV去除掉落的晶状体碎片与延迟病例的结果相似。需要进一步研究的心理效益，患者接受脱落的晶状体摘除术早于其他。

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.