Lens-iris diaphragm retropulsion syndrome during phacoemulsification in vitrectomized eyes

To assess the incidence and associations of lens-iris diaphragm retropulsion syndrome (LIDRS) during phacoemulsification in patients who have had vitrectomy.

Sunderland Eye Infirmary, Sunderland, United Kingdom.

Case series.

The LIDRS was categorized into none, mild, and moderate/severe. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of increased LIDRS severity were estimated.

Of the 75 eyes (75 patients) included, 35 (46.7%) had no LIDRS and 40 (53.3%) had LIDRS. The odds of increased LIDRS severity decreased significantly with age (OR = 0.92; 95% CI, 0.88-0.97) (P=.001) and increased with increasing axial length (AL) (OR = 3.26; 95% CI, 2.04-5.20) (P<.001) and anterior chamber depth (OR = 6.90; 95% CI, 2.00-23.8) (P=.002). The odds were greater in extensive vitrectomy than in limited vitrectomy (OR = 4.40; 95% CI, 1.64-11.84) (P=.003) and in men than in women (OR = 3.39; 95% CI, 1.40-8.23) (P=.007). The adjusted odds of increased LIDRS severity were significantly greater in extensive vitrectomy than in limited vitrectomy (adjusted OR = 4.42; 95% CI, 1.19-16.45) (P=.027) and with increasing AL (adjusted OR = 3.05; 95% CI, 1.86-5.01) (P<.001).

Lens-iris diaphragm retropulsion syndrome occurred frequently in eyes with previous vitrectomy. Several identifiable factors had a significant association with the occurrence of LIDRS, and these could be used to help in the preoperative counseling of patients and in surgical planning.