Pars Plana Vitrectomy for Retained Lens Fragments: Visual Outcomes and Complications in the IRIS Registry

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Retinal Surgery

Background:

• Retained lens fragments (RLF) after cataract surgery can lead to vision impairment.
• Pars plana vitrectomy (PPV) is a surgical option for managing RLF.
• Optimizing visual acuity (VA) and minimizing complications are key goals in RLF management.

Purpose of the Study:

• To evaluate visual acuity (VA) outcomes after pars plana vitrectomy (PPV) for retained lens fragments (RLF).
• To assess postoperative complications following PPV for RLF.
• To identify predictors of good and poor visual outcomes after PPV for RLF.

Main Methods:

• Retrospective cohort study using the IRIS Registry (2013-2022).
• Identified eyes undergoing PPV for RLF within 8 weeks of cataract surgery.
• Multivariable regression analyzed predictors of VA at 3 months, excluding eyes with comorbidities.

Main Results:

• Mean logMAR VA improved post-PPV. Same-day PPV correlated with fewer complications (e.g., ocular hypertension, corneal edema, uveitis, endophthalmitis).
• Intraocular lens (IOL) implantation before PPV predicted better vision.
• Worse outcomes linked to delayed PPV (>1 week), Black race, older age, and complications like corneal edema and rhegmatogenous retinal detachment (RRD).

Conclusions:

• Same-day PPV significantly reduces postoperative complications.
• IOL implantation prior to PPV enhances visual recovery.
• Early intervention and tailored surgical planning are crucial for optimal RLF management outcomes.