Long-term safety and functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens implantation.

Abstract

PURPOSE:

To investigate the complication profile and the long-term functional outcome of combined pars plana vitrectomy and scleral-fixated sutured posterior chamber lens (PC IOL) implantation.

DESIGN:

Retrospective, consecutive, interventional case series.

METHODS:

The records of 63 patients (mean age, 67.5 years) were reviewed retrospectively (follow-up, 12 to 132 months; mean, 43.5 months). The underlying ocular pathologic features; the intraoperative, early (within two weeks after surgery), and late complications (more than two weeks after surgery); final best-corrected visual acuity (BCVA); and the refractive outcome were recorded.

RESULTS:

Fifty-nine of 63 procedures (93.7%) were performed without complications. Intraoperative complications included vitreous hemorrhage (n = 2), a retinal tear (n = 1), and a rupture of the iris base (n = 1). Early complications included transient raise of intraocular pressure (IOP; n = 19), transient vitreous hemorrhage (n = 2), scleral tunnel insufficiency (n = 5), pupillary capture of intraocular lens [IOL] (n = 6), persistent vitreous (n = 3), and choroidal hemorrhage (n = 1). Late complications occurred in 12 patients: rhegmatogenous retinal detachment (n = 4), proliferative vitreoretinopathy retinal detachment secondary to the underlying ocular pathologic features (n = 2), choroidal hemorrhage (n = 1), macular pucker (n = 1), and IOL dislocation (n = 4), including two cases of suture break. Mean BCVA in logarithm of the minimum angle of resolution units improved significantly from 1.025 (standard deviation [SD], 0.654) to 0.766 (SD, 0.750; P = .03). Mean cylindric equivalent significantly changed from 0.92 diopters (D; SD, 1.075) to 1.76 D (SD, 1.344; P = .005).

CONCLUSIONS:

The surgical procedures were performed safely in approximately 94% of patients. Most postoperative complications were minor: significant ones occurred in approximately 20%, whereas suture breaks were observed rarely. The only moderate long-term functional improvement in this case series was mainly determined by the underlying ocular pathologic features.

• Authors: Gundula Bading, Jost Hillenkamp, Helmut G Sachs, Veit-Peter Gabel, Carsten Framme
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 144 Issue 3 Pg. 371-377 (Sep 2007) ISSN: 0002-9394 [Print] United States
• PMID: 17624290 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Aphakia, Postcataract (surgery)
• Female
• Humans
• Intraoperative Complications
• Lens Implantation, Intraocular (adverse effects, methods)
• Male
• Middle Aged
• Postoperative Complications
• Refraction, Ocular
• Retrospective Studies
• Sclera (surgery)
• Suture Techniques
• Visual Acuity (physiology)
• Vitrectomy (adverse effects, methods)