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The risk of rhegmatogenous retinal detachment following anterior vitrectomy during cataract surgery: with versus without pars plana vitrectomy

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Abstract

Purpose

To compare the rates of rhegmatogenous retinal detachment (RRD) following an anterior vitrectomy (AV) alone during cataract surgery, compared to cases requiring a subsequent pars plana vitrectomy (PPV) for dropped nuclear lens fragments (DNLFs).

Methods

Retrospective electronic note review of consecutive patients with a posterior capsular rupture (PCR) requiring either AV or subsequent PPV for DNLF over a 5-year period.

Results

A total of 20,235 cataract operations were performed during the defined period with 199 cases (eyes) of PCR (0.98%). One hundred forty-four of these (72.4%) were managed with AV, and the remaining 55 cases were further complicated by DNLF and thus underwent secondary PPVs. A total of 80.0% of cases in the AV group had a final BCVA of 0.30 logMAR or better, and 77.35% in the DNLF group had a BCVA of 0.30 logMAR or better (p = 0.069). Final BCVA was 0.30 (range—0.18 to 3.0) in the AV group and 0.32 (range—0.18 to 1.8) in the DNLF group (p = 0.82). Final BCVA in those patients who suffered a RRD was poorer than the rest of the cohort in the AV group (p = 0.03). Seven of 144 cases in the AV group went on to develop a RRD with a median time of 11 months (range 1–18 months). None of the cases in the DNLF group went on to develop a RRD (P = 0.048).

Conclusion

Following an anterior vitrectomy during complicated cataract surgery, the risk of RRD may be lower in patients who require a subsequent PPV for management of DNLF compared to patients who are managed with anterior vitrectomy alone.

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Authors and Affiliations

  1. Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK

    Khayam Naderi, Felicity Allen, Samir Dowlut, Niral Karia & Aman Chandra

  2. Faculty of Medical Sciences, Anglia Ruskin University, Chelmsford, Essex, CM11SQ, UK

    Aman Chandra

Authors
  1. Khayam Naderi
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  2. Felicity Allen
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  3. Samir Dowlut
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  4. Niral Karia
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  5. Aman Chandra
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Correspondence to Khayam Naderi or Aman Chandra.

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This project was registered and approved by the local institution’s audit and research department. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, and the UK Data Protection Act.

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Naderi, K., Allen, F., Dowlut, S. et al. The risk of rhegmatogenous retinal detachment following anterior vitrectomy during cataract surgery: with versus without pars plana vitrectomy. Graefes Arch Clin Exp Ophthalmol 258, 2425–2429 (2020). https://doi.org/10.1007/s00417-020-04843-0

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  • DOI: https://doi.org/10.1007/s00417-020-04843-0

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