Chan, EW;
Yang, E;
Eldeeb, M;
Bainbridge, JW;
da Cruz, L;
Sullivan, PS;
Muqit, MM;
... Wickham, L; + view all
(2020)
Contemporary Outcomes and Prognostic Factors of 23-Gauge Vitrectomy for Retained Lens Fragments after Phacoemulsification.
American Journal of Ophthalmology
, 219
pp. 271-283.
10.1016/j.ajo.2020.05.028.
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Abstract
PURPOSE: To provide data on VA outcomes and prognostic factors of micro-incision 23-gauge vitrectomy (MIVS) for retained lens fragments after complicated cataract surgery. DESIGN: Retrospective, interventional case series from 2012 to 2017. METHODS: Pre-cataract surgery and intra-operative (vitrectomy) parameters, post-vitrectomy complications, and best-corrected visual acuities (BCVA), were identified. Vitrectomy was performed as early as corneal clarity permitted. Univariate and multivariate logistic regression were used to characterize factors associated with achieving VA better than 20/40, or worse than 20/200 at 6 months. RESULTS: This study included 291 consecutive eyes (291 patients). LogMAR BCVA improved from 0.73 ± 0.70 before cataract surgery to 0.46 ± 0.63 (p<0.001) after vitrectomy. The pre-vitrectomy VA was 1.43 ± 0.79. At 6 months, 183 (62.9%) and 45 patients (15.5%) achieved BCVAs better than 20/40, and worse than 20/200, respectively. Most frequent complications were de novo ocular hypertension (29 eyes, 10%) and transient cystoid macular edema (CME) (25 eyes, 8.6%). Post-vitrectomy retinal detachment occurred in 9 eyes (3.1%). Final VA of 20/40 or better was independently associated only with better pre-cataract surgery VA, age <75 years, absence of pre-existing diabetic (DME) or post-vitrectomy persistent CME (p<0.05). Only poorer pre-cataract surgery VA, delaying vitrectomy to later than 2 weeks, and final aphakic status, were independently predictive of 20/200 or worse VA (p<0.05). CONCLUSION: Contemporary VA outcomes of 23-gauge vitrectomy for retained lens fragments are comparable with that of prior predominantly non-MIVS cohorts, but fall short of benchmarks for uncomplicated cataract surgery. IOL type or timing of placement do not impact final VA.
| Type: | Article |
|---|---|
| Title: | Contemporary Outcomes and Prognostic Factors of 23-Gauge Vitrectomy for Retained Lens Fragments after Phacoemulsification |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2020.05.028 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2020.05.028 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10100417 |
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