REMOVAL OF RETAINED LENS FRAGMENTS AFTER PHACOEMULSIFICATION REVERSESSECONDARY GLAUCOMA AND RESTORES VISUAL-ACUITY

Purpose: The purpose of the study is to evaluate the effect of vitrect omy on secondary glaucoma and visual acuity outcomes in patients with retained lens fragments after phacoemulsification. Methods: A retrospe ctive analysis of 126 patients who had vitrectomy for retained lens fr agments after phacoemulsification during the 3-year period between Jan uary 1, 1993, and December 31, 1995. Results: Glaucoma, defined as an intraocular pressure of greater than or equal to 30 mmHg, occurred in 42 (36.8%) of 114 patients before vitrectomy and in 4 patients (3.2%) of 126 after vitrectomy. There were no differences in the rates of per sistent glaucoma regardless of the intervals between cataract surgery and the vitrectomy: less than or equal to 1 week, 2 patients (4.1%); g reater than 1 week to less than or equal to 4 weeks, 1 patient (2.5%) and greater than 4 weeks, 1 patient (2.6%). The visual acuity was 20/4 0 or better in 13 patients (11.4%) before vitrectomy and in 75 patient s (59.5%) after vitrectomy. The rates of visual acuity 20/40 or better also were similar for all intervals: less than or equal to 1 week, 29 patients (59.2%); greater than 1 week to less than or equal to 4 week s, 22 patients (56.4%) and greater than 4 weeks, 24 patients (63.1%). Conclusions: Vitrectomy for removal of retained lens fragments reduces secondary glaucoma and yields favorable visual acuity outcomes. In ey es with elevated intraocular pressure, early vitrectomy generally is r ecommended, but delayed vitrectomy also has favorable outcomes.