Retinal breaks in vitrectomy for retained lens fragments.

Purpose: To describe the incidence and outcome of retinal breaks in vitrectomy for retained lens fragments.

Methods: This is a retrospective noncomparative interventional case series. Medical records of consecutive cases of vitrectomy for retained lens fragments over a period of 4 years were reviewed. Main outcome measures were incidence of breaks, visual acuity outcome, and occurrence of postoperative complications.

Results: We included 89 consecutive cases in 89 patients. The median interval between cataract surgery and vitrectomy was 2 days (range, 0-106 days). Visual acuity at last follow-up was ≥ 0.5 in 70% of cases. During surgery, retinal breaks were found in 29% of cases. Induction of a posterior vitreous detachment, the use of a fragmatome, or delay between cataract surgery and vitrectomy did not influence retinal break incidence. Postoperative retinal detachment occurred in only 2% of cases. Other complications were intraoperative choroidal hemorrhage in 1 case, postoperative macular pucker in 2, postoperative macular edema in 1, and glaucoma in 2 cases.

Conclusion: We identified a high number of retinal breaks during vitrectomy for retained lens fragments. Prophylactic treatment of breaks and other areas of retinal traction seem to reduce the risk of postoperative retinal detachment.