Same-day versus delayed vitrectomy with lensectomy for the management of retained lens fragments.
| Autor: | Colyer MH; The Retina Group of Washington, Chevy Chase, Maryland, USA. colyer_m@yahoo.com, Berinstein DM, Khan NJ, Weichel ED, Lai MM, Deegan WF, Katira RC, Phillips WB, Sanders RJ, Garfinkel RA |
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| Jazyk: | angličtina |
| Zdroj: | Retina (Philadelphia, Pa.) [Retina] 2011 Sep; Vol. 31 (8), pp. 1534-40. |
| DOI: | 10.1097/IAE.0b013e31821800fc |
| Abstrakt: | Purpose: To evaluate whether performing same-day pars plana vitrectomy versus delayed pars plana vitrectomy affects visual outcomes and ocular morbidity of patients with retained lens fragments after a complicated cataract surgery. Methods: Retrospective, comparative case series of 172 eyes of 171 patients with retained lens fragments undergoing 3-port pars plana vitrectomy using 20-, 23-, or 25-gauge instrumentation between 2005 and 2008. Outcome measures included best-corrected visual acuity at 6 months, final best-corrected visual acuity, and postoperative complications such as cystoid macular edema, intraocular pressure elevation, retinal detachment, vitreous hemorrhage, choroidal hemorrhage, and endophthalmitis. Results: The median age was 75 ± 0.8 years. The mean time to vitrectomy for the delayed group was 15 ± 2 days. The preoperative logarithm of the minimum angle of resolution best-corrected visual acuity for immediate vitrectomy was 0.73 ± 0.09 versus 0.72 ± 0.06 for delayed vitrectomy. Six-month logarithm of the minimum angle of resolution acuity was 0.44 ± 0.09 for same-day vitrectomy compared with 0.44 ± 0.05 for delayed vitrectomy (P = 0.97, 2-tailed t-test). Of 59 eyes undergoing immediate vitrectomy, 17 (29%) experienced postoperative complications, while 38 of 113 eyes (34%), experienced complications if undergoing delayed vitrectomy (Fisher exact test, P = 0.61). Overall, the most common complication was cystoid macular edema occurring in 25 of 172 eyes (15%). Conclusion: The outcomes of same-day pars plana vitrectomy appear to be similar to non-same-day pars plana vitrectomy. The risks and benefits related to the timing of vitrectomy after a complicated cataract surgery should be carefully discussed with each patient. Further investigation is warranted to establish an optimal time for surgical planning. |
| Databáze: | MEDLINE |
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