Outcomes in eyes with retained lens fragments undergoing pars plana lensectomy and scleral-fixated intraocular lens insertion.

Purpose: To report the visual outcomes and complications in eyes with retained lens fragments (RLF) following cataract surgery undergoing pars plana lensectomy (PPL) and scleral-fixated intraocular lens insertion (SFIOL).

Methods: Patients with RLF who underwent pars plana vitrectomy (PPV), PPL, and SFIOL insertion from January 2015 to December 2022 were included. The visual acuity (VA) outcomes and complication rates were compared between those receiving sutured versus sutureless SFIOL insertion as well as those undergoing SFIOL insertion at the time of PPV and PPL versus those undergoing SFIOL insertion during a subsequent surgery.

Results: 65 eyes of 65 patients were included. Median (interquartile range) pre-operative logarithm of the minimum angle of resolution (logMAR) VA was 2.3 (2-2.3; Snellen: HM). The median logMAR VA improved to 0.14 (Snellen: 20/100), at the most-recent follow-up (p<0.001, Hodges-Lehmann estimator:1.56, 95% confidence interval -1.30 to -1.71). There was no statistically significant difference in VA outcomes and the complication rates, including cystoid macular edema, corneal edema, and retinal detachment, regardless of technique or timing of SFIOL insertion.

Conclusions: In this retrospective study with small sample size, similar visual acuity outcomes and complication rates were observed regardless of the timing or technique of SFIOL insertion.