Management of nucleus loss into the vitreous: long term follow up in 63 patients

Pedro Romero-Aroca, Juan Fernández-Ballart, Isabel Méndez-Marín, Merce Salvat-Serra, Marc Baget-Bernaldiz, Jose A Buil-Calvo

Servicio de Oftalmología, Hospital Universitario Sant Joan de Reus, Barcelona, Spain; Departamento de Medicina y Cirugía, Universidad Rovira y Virgili, Tarragona, Spain

Background: The aim of present study is to determine the long-term results of patients who undergo pars plana vitrectomy after retained nucleus into the vitreous.

Setting: Service of Ophthalmology, Hospital Universitari St Joan, Reus (Barcelona), Spain.

Methods: Retrospective, noncomparative, consecutive case series. Medical records were reviewed of all patients who underwent pars plana vitrectomy for retained nucleus into the vitreous after complicated cataract surgery, over a 9-year period between August 1, 1997 and July 31, 2005.

Result: The incidence of retained lens fragments was 0.57% (63 patients), the postoperative visual acuity was higher than 20/40 in 59.60% and fell to 48.93% by the end of the study, and was related to the presence of CME and retinal detachment. The CME appeared in 31.91% of the patients and was related to preoperative uveitis an corneal edema. In the group of patients on whom the vitrectomy was performed at the time of cataract complication, visual acuity was higher than 20/40 in 77.77%, and no one developed secondary glaucoma or uveitis.

Conclusion: Being retrospective, our study was not result conclusive. Despite the initial good results of these patients after PPV surgery, follow-up should be accurate and over a long period of time in order to minimize postoperative complications such as retinal detachment, retinal breaks, secondary glaucoma and CME.

Keywords: Nucleus loss, retained lens fragment, incidence of retained lens fragments, pars plana vitrectomy, phacoemulsification, cystoid macular edema