Dropped lens fragments retrieval using endoscopy-assisted pars plana vitrectomy in patients with corneal opacity.

Abstract

Purpose: To characterize the surgical outcomes of endoscopy-assisted pars plana vitrectomy (E-PPV) in dropped lens fragments retrieval in patients with corneal opacity.

Background: Corneal opacity may delay dropped lens fragment retrieval because of limited fundus view. E-PPV permits posterior segment visualization through corneal opacity. There is limited data on E-PPV use for dropped lens fragments retrieval in the literature.

Design: Retrospective cohort study.

Methodology: A retrospective chart review was performed of dropped lens fragments retrieval procedures done between 2013 and 2023 at a tertiary referral center. Data was collected on the surgical approach, visual acuity (VA) and intraocular pressure (IOP) as well as complication rates including retinal detachment (RD), cystoid macular edema (CME), and epiretinal membrane formation (ERM). Statistical analysis was performed using t-tests and chi-squared tests. Statistical significance was defined as a p-value of 0.05.

Results: There were 74 patients who met the inclusion criteria (31 patients had E-PPV, and 43 patients had standard pars plana vitrectomy (S-PPV)). Groups were balance in age and gender. Postoperative CME rate was 25.8% after E-PPV and 25.58% after S-PPV (p-value: 0.95). Postoperative RD rate was 0% after E-PPV and 7% S-PPV (p-value: 0.13). After one-year, there was no difference in postoperative VA, IOP and rates of RD, CME, or ERM between groups. Interval time to dropped lens retrieval did not change the final outcome in either group.

Conclusion: This study showed that performing E-PPV to extract dropped lens fragments through corneal opacity had similar final outcomes compared to S-PPV, regardless of the interval time to surgery following the dropped lens fragments. Removing dropped lens fragments using E-PPV before cornea opacity clearance provided similar outcome to delayed cases. Further studies are needed on the psychological benefit on patients undergoing dropped lens removal sooner than others.