Two Surgical Approaches for Intraocular Lens Dislocation: Pars Plana Vitrectomy Versus Core Vitrectomy with Lens
Angelika Schuknecht1, Josephine Wachtl1, Johannes Fleischhauer1
1Talacker Augen Zentrum Zürich (TAZZ), Zürich, Switzerland.
Klinische Monatsblatter Fur Augenheilkunde
|April 26, 2022
Summary
Core vitrectomy and pars plana vitrectomy are equally effective and safe for managing dislocated intraocular lenses. Both procedures significantly reduce intraocular pressure and improve visual acuity, with comparable safety profiles.
Area of Science:
- Ophthalmology
- Surgical Techniques
- Retinal Surgery
Background:
- Intraocular lens (IOL) dislocation is a significant complication requiring surgical intervention.
- Lens exchange procedures aim to restore visual function and ocular health.
- Vitrectomy techniques are employed to manage complications associated with IOL dislocation.
Purpose of the Study:
- To compare the efficacy and safety of core vitrectomy versus pars plana vitrectomy for lens exchange in patients with dislocated intraocular lenses.
- To evaluate the impact of each surgical approach on intraocular pressure (IOP) and best-corrected visual acuity (BCVA).
- To assess the incidence of postoperative complications associated with each technique.
Main Methods:
- Retrospective study of 124 eyes with dislocated IOLs undergoing lens exchange.
- Procedures performed by two surgeons between March 2016 and December 2019.
- Analysis of IOP and BCVA preoperatively and up to 12 months postoperatively, along with complication data.
Main Results:
- Glaucoma was more prevalent in the core vitrectomy group (78%) compared to the pars plana vitrectomy group (32%).
- Both groups showed significant IOP reduction post-surgery (p < 0.001).
- Pars plana vitrectomy group demonstrated a significant improvement in BCVA (p < 0.001), while core vitrectomy showed no significant change (p = 0.598).
- Postoperative pressure decompensation was higher in the core vitrectomy group (20%) versus pars plana vitrectomy (6%).
Conclusions:
- Core vitrectomy and pars plana vitrectomy with lens exchange are comparable in managing intraocular lens dislocation.
- Both techniques effectively reduce intraocular pressure.
- Pars plana vitrectomy may offer superior visual acuity outcomes and a lower risk of pressure decompensation.
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