THE MANAGEMENT OF DISLOCATED LENS MATERIAL AFTER PHACOEMULSIFICATION

Purpose To determine the visual outcome, prognostic factors, and effec t of timing of surgical intervention in patients with retained lens fr agments after phacoemulsification. Methods A retrospective review was carried out of the notes of 44 consecutive patients who suffered poste rior dislocation of lens fragments during phacoemulsification, of whom 34 underwent vitrectomy. Results The presence of severe uveitis at pr esentation was a significant predictor of a final visual acuity of les s than 6/60 (p = 0.002). A raised intraocular pressure at presentation (> 29 mmHg) significantly increased the risk of chronic glaucoma (p = 0.0279), but there was no association between glaucoma and delay in v itrectomy. Patients operated on within 1 week of cataract surgery obta ined a better visual outcome (64.7% of patients achieved 6/12 or bette r visual acuity) than those operated on later than 1 week (41% obtaine d 6/12), but this difference did not reach statistical significance. C onclusions The trend towards a better visual outcome with early vitrec tomy was not statistically significant. A large prospective trial is i ndicated to determine the optimum time for vitrectomy in these patient s.