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Visual and Anatomical Outcomes of Pars Plana Vitrectomy for Dropped Nucleus After Phacoemulsification Publisher



Lashgari A1 ; Kabiri M1 ; Ramezani A2, 3 ; Entezari M1 ; Karimi S1, 3 ; Kakaei S1 ; Yaseri M1, 4 ; Nikkhah H1, 3
Authors
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Authors Affiliations
  1. 1. Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, No. 23, Boostan 9 St., Paidarfard St., Pasdaran Ave., Tehran, 16666, Iran
  2. 2. Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  4. 4. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Ophthalmic and Vision Research Published:2018


Abstract

Purpose: To determine the prognostic factors and visual and anatomic outcomes of pars plana vitrectomy (PPV) in patients with dropped nucleus following complicated phacoemulsification (PE). Methods: The records of patients with complicated PE who underwent PPV to remove posteriorly dislocated nucleus fragments from January 2011 to December 2014 were retrospectively reviewed. Results: Of 43 patients, 36 patients (36 eyes) were included with mean age of 73 ± 9.5 years and mean follow-up duration of 23.8 ± 15.3 (range 4-53) months. The mean interval between cataract surgery and PPV was 11.5 ± 9.6 (range 1-45) days. The pre-PPV mean best-corrected visual acuity (VA) was 1.04 ± 0.24 logMAR, which improved to 0.46 ± 0.18 logMAR (P < 0.001). Pre-PPV VA ≥20/200 was significantly associated with good final VA ≥20/40 (P = 0.002). Implantation of intraocular lens (IOL) at the time of complicated PE and complicated course after PPV were significantly associated with poor visual outcome of <20/40 (P = 0.041 and P < 0.001, respectively). However, the timing of PPV, route of nucleus removal, and final IOL status were not significantly associated with the visual outcome. The most frequent causes of poor visual outcome were optic atrophy, cystoid and/or diabetic macular edema, history of rhegmatogenous retinal detachment, and pre-existing eye disease (age-related macular degeneration). Conclusion: PPV for dropped nucleus was associated with improved VA. Better pre-PPV VA was associated with good visual outcome, while inserting IOL at the time of complicated PE, and complicated course after PPV were associated with poor visual outcome. © 2018 Medknow Publications.All Rights Reserved.